The Evidence that Salt Raises Blood Pressure

The Evidence that Salt Raises Blood Pressure
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Rather than reformulate their products with less sodium and save lives, food manufacturers have lobbied governments, refused to cooperate, encouraged misinformation campaigns, and tried to discredit the evidence.


Like any group with vested interests, the food industry resists regulation. Faced with a growing scientific consensus that salt increases blood pressure, major food manufacturers have adopted desperate measures to try to stop governments from recommending salt reduction. Rather than reformulate their products and save lives, manufacturers have lobbied governments, refused to cooperate, encouraged misinformation campaigns, and tried to discredit the evidence. After all, salt is the main source of flavor in processed foods. Of course, they could improve the flavor by adding real ingredients, but like making a pop-tart with actual strawberries, that would be more expensive and cut into profits.

The evidence that they’re trying to discredit includes double-blind randomized trials dating back decades. You take people with high blood pressure, put them on a sodium-restricted diet, and their blood pressure drops. Then, if you keep them on the low-salt diet and add a placebo, nothing happens. But if you instead give them salt in the form of a time-release sodium pill, their blood pressure goes back up. And, the more sodium you secretly give them, the higher their blood pressure climbs.

Even just a single meal can do it. If you take people with normal blood pressure and give them a bowl of soup containing  the amount of salt a regular meal might contain, their blood pressure goes up over the next three hours compared to the same soup with no added salt. Why though? High blood pressure appears to be our body’s way to push the excess salt out of our system. 

Dozens of such studies have been done, showing that if we reduce our salt intake, we reduce our blood pressure, and the greater the reduction, the greater the benefit. The so-called DASH diet, which I’ve covered before, is commonly used to capture the blood pressure benefits of a more plant-based population, but how do we know the benefits have anything to do with eating less salt instead of just from eating more fruits and vegetables? Because it was put to the test. Sure, eating healthier lowers blood pressure no matter how much salt we eat, but even if we stick to the same diet, lowering salt helps independently of other dietary improvements.

You can do this on a community level. You take two matched villages that both start out about the same. In the control village, on average, blood pressures went up or stayed the same. But in the village where they were able to cut down on salt intake, blood pressures went down, whereas if we don’t cut down, chronic high salt intake can lead to a gradual increase in blood pressure throughout life, as shown in the famous Intersalt study.

52 centers from 32 countries participated with hundreds of participants each, and four of those centers were in populations that ate so little salt they actually complied with the American Heart Association guidelines for salt reduction, something less than 1% of Americans achieve. In a population where everyone makes the cut off, not only was not a single case of high blood pressure found, but the older folks had the same blood pressure as the teenagers.

This is why including such populations is so important. If you just look at the 48 centers in the industrialized Western world, there does not appear to be any relationship between rising blood pressure with age and how much sodium people are getting every day. Just looks like a random assortment of dots. Now, the salt industry looks at this and says “Aha!—see I told you so, no relationship between salt and increasing blood pressures as you get older.” But maybe that’s because they’re all getting too much salt.

The American Heart Association recommendation is that everyone get their salt intake under here; so, they were all way over. You can imagine a similar result if this was instead lung cancer rates versus packs of cigarettes smoked every year. Whether you smoked 150 packs a year or 200 packs a year, it might not make much of a difference. To see a relationship between smoking and cancer, you’d have to compare smokers to those who rarely light up. And indeed, if you add in those low-salt populations that get little or no high blood pressure as they get older, you end up with a highly statistically significant relationship between increasing sodium and increasing blood pressure, but only if you include people that actually comply with the salt guidelines. As with so many lifestyle interventions, they only work if you actually do it.


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Doctor's Note

This is part of my extended dive into the manufactured controversy about the health effects of sodium. Check out High Blood Pressure May Be a Choice and Sprinkling Doubt: Taking Sodium Skeptics with a Pinch of Salt. And I’ve got more sodium videos on the way. Subscribe to my daily, weekly, or monthly video updates to stay tuned.

But what if cutting back on salt means everything tastes like cardboard? Never fear! Check out Changing Our Taste Buds.

For more on the DASH diet, check out How to Treat High Blood Pressure with Diet. And for more on the blood pressures of those on plant-based, salt-shaker-free diets, How to Prevent High Blood Pressure with Diet.


282 responses to “The Evidence that Salt Raises Blood Pressure

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    1. Like you, I am living proof that salt raises blood pressure, precisely because my blood pressure is low. When it falls below my comfort level, I use a lot of salt. It goes up very quickly. — very effective.

      1. Yes, but I’ve never experienced that correlation. Except where mine was pushed up with intravenous fluids last time it was a real issue (blood-loss caused hypotension). How much salt in saline solution anyway? I can’t donate blood, takes too long to get over it. I tried, fell out at the Red Cross!

        1. I living proof of the exact opposite, I never had salt ever, hearing it was bad for my blood pressure. I developed back pain at age 13 and tendonitis at age 30 from an Iodine deficiency. I never had low blood pressure. I had just one half teaspoon of salt. I didn’t need sleep in days from sleeping 12 hours a day. My heartbeat vanished. I can’t feel my heartbeat in my chest anymore. It’s like Joy, like the sensation of a near death experience. If you do drop or dip, with Iodine, make sure you are ready for shock. It would just take one day’s worth of Iodine to make your heartbeat go away or be much softer. Iodine seems to cure all my pain. Perhaps Opium is just a source of bromine. Just a smaller halide Bromine. Iodine is really good for you. Forms of Iodine seem to reduce your risk of heart attack by 90 percent or more. I never had salt. I became very sleepy, sleeping 12 hours a day. With just a little salt I sleep much less. The feeling of the sodium going into my left ventricle was so pleasurable it hurt. I think the evidence that salt causes high blood pressure is flawed. Take the sodium pill experiment. They were probably aware under those circumstances they were being poisoned. Take the soup experiment. How could you eat soup with out salt? Take the villagers. They were probably told no salt was the cure for anxiety. High blood pressure is probably related to anxiety. Selenium seems to be the cure for anxiety. Magnesium and Sulfur also greatly reduce blood pressure. Perhaps high blood pressure as anxiety is treated with low salt, but that does not seem to be the cure. I am a 34 year man old living in Maryland who enjoys easier, less sleep because I eat salt. If you are in pain, I wish you luck with how you approach getting a day’s worth of Iodine. It’s magic, praise it, I apologize to it, it cures pain, Selenium cures anxiety. I would love Selenium in this world and circumstances forever, I would move on with it. Praise to salt, it has freed me and given me easier, better and less sleep.

          1. Salt is not iodine. Iodine is added to salt. You can get it from other sources, but it was added to salt because a deficiency of iodine was so common that the devised solution was to add it to something that is so commonly used that it would be nearly impossible for anyone consuming that something to have the iodine deficiency. (The soil in some of the US is so bereft of iodine that plant foods grown in it have almost none, and that gave rise to the phrase “the goiter belt” to designate a large swath from the northeast to midwest and plains that had many goiter sufferers due to the deficiency.)

            You don’t have to consume table salt to get iodine, but it is easy to get iodine that way–because iodine is added to most table salt. (Not kosher salt, and not rock salts and the fru-fru pinks, blacks, lavas, etc.)

            1. Salt is not the enemy. It is the process of unnaturally iodizing the salt that is poisonous to the body. Use of sea or himalayan salt has many benefits without causing trouble in most people…comprised of minerals and electrical charges, your body needs salts for balance.

              1. Iodine in salt is not poisonous to the body. Nor is the process of adding iodine poisonous. And Himalayan salt is no more composed of “electrical charges” than anything else.

              2. the ‘clinical trials’ should have really tested maintaining sodium/potassium balance which is easier in a plant based diet with salt added for cooking.

        2. I think you might be eating too little salt to see a reaction? My bp is low too and I find myself eating teaspoons every other hour on those fainting days really help. That is in addition to my regular salty meal intake.

          1. My current intake is low, but it’s not super low. I’ve done superlow before. BUT I’ve spent most of my life eating lots of processed and salty foods. Country ham, anchovies, and the like have been favorites. Methinks the fact is that: I’m not “salt sensitive”.

    2. Wade – I am just like you when it comes to BP and totally understand.. I am a 63 y.o. women whose blood pressure runs 90/60. If I totally eliminate salt, I feel dizzy and have nearly blacked out. When I had surgery a number of years ago, the surgeons had to stand the operating table on end to keep my BP up.

      I have been vegetarian for 20 years and WFPB or 6 or 7 years. I don’t cook with salt but add a light sprinkling at the table. My husband and I eat in restaurants about 2 x a week–mainly salads.. I prepare all our food i.e. beans, legumes from scratch and use no salt canned beans when I have to. On the exact same diet and no salt added at the table, my husband’s BP is about 120/60.

      I don’t know how to account for this difference, I just no I need a tiny bit of added salt each day. I am going to measure out 1/4 teaspoon so see how much of it I actually use.

      Question: does anyone know if this low BP relates to clear arteries?

      1. According to Dr. Alan Goldhamer, owner of the TrueNorth Health Center in Santa Rosa, California, who has offered water-only fasting and healthy (SOS-free) eating to residential patients for three decades (and who has published peer-reviewed research on high blood pressure along with Dr. T. Colin Campbell), 90/60 is actually HEALTHY blood pressure. 120/80 is simply what the western medical system considers “normal,” among a sick, salt-addicted population. He does not even consider 80/50 to be low … These are the kinds of numbers he sees among healthy people who don’t eat salt.

    3. Was just reading Chris reskers piece on the issue. He mentioned that in the remote populations you mention that there are too many other variables such as low levels of obesity, higher levels of exercise ect

      1. Hello Dan,
        I am a family doctor with a private practice in lifestyle medicine. Besides my MD, I also have a master’s degree in epidemiology. You mention an assertion from Chris Resker (with whom I am not familiar) that other factors (obesity, exercise) could serve as confounding variables which might invalidate Dr. G.’s assertion that salt intake is strongly correlated with blood pressure. It is true that in observational studies, such as he cites in comparing one village with another, it is difficult to infer a causal relationship between two variables — mainly because of possible confounding variables. However, note that Dr. G. also references “double-blind randomized trials dating back decades” — see his list of “Sources Cited”, which have pretty much proven the relationship between salt intake and blood pressure.

        So, it’s fine to criticize a particular study that he cites, but in my view, this issue has been pretty conclusively settled. Of course, you can still find lots of controversy about this topic, for the reasons that Dr. G. mentions above.

        Dr. Jon
        Volunteer moderator for

  1. I would be curious if research has been done looking at arterial dysfunction seen with the typical American diet is in part why we see this increase in BP with sodium ingestion. Since salt will increase intravascular osmolarity and then volume and then the inflammatory effect of diet paralyzes arteries, the arteries would be unable to relax to accept the increase volume load.
    I would be curious to investigate salt intake effect on a population that has flexible arteries: do we see this increase in BP, is it perhaps a less noticeable increase? Though to find these subjects would be a difficult task…

      1. That’s right. People who rationalize that they don’t have high blood pressure and thus don’t need to think about salt consumption are like people who eat dairy because they’re not lactose intolerant. Both still do their damage, whether or not the symptoms are obvious.

      2. Careful, the study that you cite was on overweight and obese individuals who were not consuming a substantial amount of potassium, right?

  2. This clears up a little of the unknown for me at least. I know the AMA recommends 1500 max, but I wasn’t sure if that was low enough until today. I do try to keep my sodium at that level, and on bad days get up to the 2200, but I’ve been stuck here struggling but not doing well at lowering it further.

          1. 1/2 tsp is almost 1200 mg of sodium. Be weary though as sodium is naturally occurring in food, such as in greens, so adding a certain measure of salt + that naturally occurring in food could be too much.

            Go to to track your intake.

            1. That’s right, whole natural vegetables do contain a small amount of sodium, and spinach, chard, celery, and celery root contain a not-insignificant amount. The TrueNorth Health Center hired me back in 2010 to perform a nutritional analysis of 92 recipes in its “Bravo!” cookbook. They put together 14 days’ worth of SOS-free (no salt-oil-sugar) meals, ranging from 1,800 to 2,700 calories per day. The sodium in that 14-day meal plan AVERAGED 1,141 mg and ranged 400 to 1,950 milligrams per day, with ZERO added salt. So given that 1,500 is a maximum, if you like supple arteries, adding no salt whatsoever (and no salty soy products like miso, Bragg, shoyu, Tamari) is actually the way to go, IMO.

              1. I noted with interest that celery is high in salt but it is often cited as a food that reduces blood pressure. Do you think that is true, that it reduces bp?

                1. I’m surprised that Dr. Greger is not distinguishing quality, non processed, mineral rich, sea salt from the processed (Morton and other), iodized, chlorinated, health devastating, salt sold on a large scale in the US. I’m not sure of his view on sodium rich celery, but assume he might be ok with this beneficial, known and praised, vegetable.

                2. It’s not just how much sodium you eat right? but also the sodium/potassium ratio. While vegetables like celery contain salt, they also contain a lot of potassium. So even if you eat a lot of celery, you sodium-potassium ratio will remain balanced.


            2. Not trying to be unpleasant, but just fyi, the correct word is wary, not weary. I’ve seen that cropping up rather frequently, so would like to see it fixed. I used to try to stop people from using the word ‘unique’ to mean unusual or different, as it actually means ‘one of a kind’. I couldn’t fight it, now we have lost the only word we had that meant one of a kind.

          2. I see what you were asking now.

            I track sodium through cronometer to help me see everything and not “wing” it. I don’t track it daily anymore, just when I make new recipes. When I first started WFPB however I did use it daily, it helped me reset portion sizes from the calorie dense old diet to the crazy amount of food you can eat now. At this point it takes just a min or two to assemble something new, add it to my diet and see how it could be used to balance out everything.

            There is a spinach lasanga I make that was crazy high in sodium, uses a lot of spinach, it is amazing how much sodium there is in spinach, you’d just not think without that website. Knowing this stuff does help to balance, because adding salt to that dish would just blow it away. Spices are another tricky one, premade chili powder often has salt in it, but you can make your own without salt very easily.

          3. There is 2325 mg of sodium in a teaspoon of plain Jane (Morton) table salt. I round that up to 2400 mg and take rough eyeball measurements using a 1/8 teaspoon measure spoon. Instead of using a salt shaker to add to my plated food, I fill the 1/8 tsp measure spoon (300 mg) and set that on the table – I sprinkle from that and eyeball what remains after eating to determine my usage.

            The only time I actually add salt while cooking is when I make large batches of red meat sauce for spaghetti. I use 1 Tbsp of salt (7200 mg sodium) in the cooking water for each pound of dry pasta, then 1 Tsp of salt (2400 mg) to each quart of freshly prepared sauce (scratch, from 3 lbs fresh plum tomatoes). The pasta absorbs .03 % sodium from the dissolved salt – that’s 216 mg of sodium absorbed from 7200 mg salt per pound of pasta.

    1. Are you blood levels of Sodium high? That might mean osmosis is leaking it from cells because you have a sodium deficiency. I think salt makes me less sleepy, if you have any at all.

  3. I was told to have no slat ever after I had a near death experience with nephrotic syndrome at age 2 1/2, still here! After that experience I starting losing quarter sized patches of hair (alopecia). I have a tiny bit of salt now at age 27 1/2 once a week only when only I add it to my food. Doc put me on steroids for 5 years as a child. I ate a “well balanced diet” my whole life and always struggled with feeling physical despair/stress despite becoming a gymnast and seeming normal. I lost all my hair at age 14 to alopecia. I since have had some regrowth about 30%. I have tried alkaline diets that made me worse.. I have tried just meat once a day, veggies and sparing few good grains. No real results yet, but I acquired high iron over the past few years. Something was still not right. So i set off on quitting anything harmful and I ended up finding Dr. Gerger on youtube that night. My life changed. I woke up a vegetarian the next day who was inspired to go full vegan despite resistance from friends and family. If you haven’t please watch his presentations. The long ones. I have been on a vegan plant based diet for a month (taking probiotics, vit d, b-12) and all my broken capillaries on my face and thighs are gone. My cellulite has dramatically reduced and I’ve lost 8 pound even though I wasn’t technically overweight,127 down to 119. Anyways I’m just trying to say this diet could really work for people. Thank you so much for all this information and everything!

    1. Great work going vegan. Do you have high blood levels of Iron? Hair loss can be a sign of an Iron deficiency. You could consider, as Dr. Greger does, eating Hibsicus tea leaves. Praises to you for your helpfulness.

    2. Are you anorexic? I love, however you have really should weigh more than 119 pounds. Yes, this diet could really work for people. How we really care. How we know you are here.

      1. Matthew Smith – Do you know how tall Heather is? 119 lbs for a petite woman is not too small. Think before you type, because you may hurt someone’s feelings.

    3. Turkey, blueberries, cranberries, wild rice, pumpkins, potatoes, corn, squash, and some beans are Native American. Your will power is enormous. You are very attractive here. Thank you I love you Heather.

      1. Thank you, I guess I wasn’t prepared emotionally to share my story seeing how it made me panic seeing the response. It was a little impulsive of me and I felt vulnerable. I will try again someday. I really do want to connect with people but it is really emotional for me. I wasn’t allowed salt my whole childhood due to the nephrotic syndrome. Now, Why would you say to eat Turkey? Also, I am 5’1. I used to have an eating disorder so i would like to think I don’t anymore seeing how much I have grown and changed my perspective from that disease. I do sometimes like having a few days here and there where I eat less.

        1. I can’t be specific since your original comment is gone, but just wanted to tell you we are ALL on a mission to improve ourselves. Be proud of your progress, none of us are perfect, the important thing is to stay on the right path and stay positive…it will get us there eventually. Sounds like you are well on the way!
          BTW, don’t eat turkey, he was just mentioning that native Americans ate it, I don’t know why… but stick with plants!

  4. Great review of the evidence and completely in line with what Walter Camp Maranda you did at Duke University back in the late 30s 40s and 50s. You one bad mama-jama!

      1. So am I, my bP was 180/94 while still horizontal in bed. I thought that at the most dehydrated time of the day it would be lower. Nope. Do you have the book?

        1. Blood pressure is said to be highest first thing in the morning. I don’t think dehydration lowers bp (although it sort of seems like it should, huh?) I am constantly dehydrated and if anything, I guess it makes it worse. I know it doesn’t make sense – they give you water pills to cause you to excrete liquid to lower your bp, but don’t they also say drink plenty of fluids? I don’t have the book. Faced with rice without anything, I decided to re-think it. If salt made my arteries stiff (and that is an if in my mind), then its likely not going to change in just a few days like I was expecting when I gave up salt to see what would happen. I am going to continue on the WFPB no oil diet I have been on for 2 years, only try to cut way down on salt – down to maybe 2/3 teaspoons a day or less. I bought some Bensons seasonings which are supposed to help. Many people claim sugar is what raises their blood pressure and I have gradually been cutting way back on that too. I do still use some for oatmeal and muffins but way less than I used to or most people use. My taste has changed so I need less to taste sweet.

          1. I read that it is too much insulin floating around for too long due to insulin resistance could cause BP to go up not sugar level per se

  5. My blood pressure is 100 / 68. Middle aged male. Extremely low salt diet – a tiny pinch of salt per day and sometimes days and weeks without any added salt; no industrially processed foods, of course. Just it a try.

    1. You might try smoked black pepper, smoked paprika, or chipotle powder for some of that smoky flavor. The smoked salt is serious though, I had an almond with applewood smoked salt and thought it was bacon.

      1. Thanks Ry! I have tried smoky smoked black pepper and paprika. I didn’t get much from the pepper, but the paprika works some times. One thing I don’t like is that the versions I seem to have access to all have silicon dioxide in them.

        re: Your almond-salt experience. :-) I so get it!

        1. Silicon dioxide is an inert ingredient. It’s like eating powdered quartz- in fact it’s the same chemical a quartz. I doesn’t react with much of anything at body temperature except perhaps hydrofluoric acid. So, I wouldn’t waste a second of time worrying about that. I just bought a bottle of Mrs. Dash salt-free garlic and herb seasoning blend at Costco. I can’t wait to try it out in my cooking

          1. guest: Thanks for this post. Looks like I was confusing/miss remembering silicon dioxide with titanium dioxide (which has some warnings on NutritionFacts). I appreciate the correction as I hate to spread misinformation.

    2. Good morning Thea!
      I wonder how much you are really getting? I believe the processed foods are key. I do cook with a little bit. Last night I made a great lentil soup with a squeeze of lemon. That really cutes down on added sodium. So I made the soup, beets, beet greens, roasted potatoes but only salted the soup. Lightly.

      1. WFPBRunner: I totally agree, cutting out processed foods and eating at restaurants are the key to getting to a healthy salt level. Sadly for myself, that’s still a work in progress. What this video is bringing home to me is that the salt thing really does matter when I can get around to addressing it — as the processed foods and restaurant visits probably need a higher priority and if I lick those issues, the salt one may become a non-issue.

        Thanks for your 2 cents!

    3. First though, how is your BP? Second, if you don’t eat processed stuff, 2/3 teaspoon is a lot of salt to sprinkle over. And if your cooking one has to consider how many days/sittings it will take to eat the meal. Put salt in the middle of the woods or field and ALL the little animals will come to it. Our craving is natural, enjoy in moderation I say.

      1. Wade: My BP is generally pretty good. The rub is that I still eat too much processed stuff and eat out too much for me to feel comfortable with my salt/sodium intake. Since my BP is usually pretty good, dealing with BP isn’t my top priority. But with videos like this one (thanks Dr. Greger?), I’m coming kicking and screaming to the table of “this too must be addressed.”

        I totally agree with you that some salt is probably fine. I just have to get to the point where *some* is truly a reasonable amount and I’m in the context of an otherwise truly healthy diet.

    4. Thea, salt is addictive in that the more one uses, less one is able to discern its presence in their food; which leads to a cycle of adding salt, which then establishes a new set point of insensitivity; which once again leads to increased usage.

      It can be a miserable experience going through the detoxifying process because ones food will taste bland in comparison, but with the judicial use of garlic, chili, herb, spices and/or citrus juices such as lemon or lime, one can get back to point where one no longer needs to salt their food, and your food will become more flavorful, not less.

      This weening process does not take very long, and is well worth doing: “every point you drop your systolic blood pressure all the way down to 90, there is a one percent reduction in mortality.” ( )

      1. Joe: Thanks for your post. I’m a huge believer in the concept of re-calibrating and evolving taste buds. I’ve experienced this myself in other areas and to some degree with salt as well. The other day, I followed the recipe to make a vegan nut cheese. I followed the salt recommendations and felt that the salt level was WAAAY to high. I think it would have tasted just fine to me a couple years ago. So, while I am no doubt still getting too much salt/sodium, I have been cutting back and my taste buds have been adjusting. Yeah biology!

        Thanks again for your post. I think it has the potential to benefit a lot of people as it does a great job of covering the issue.

      2. It would be very difficult to get less than 500 mg of sodium when eating at least 2,000 calories per day of whole, natural plants. As I posted above, I ran the numbers for 14 SOS-free days’ worth of meal plans in the Bravo! cookbook, and the average sodium was 1,141 mg per day, with the lowest day weighing in at 400 mg. Just eat plants!

        1. I occasionally log my food diary into, which will give you a nutrient breakdown, in order to get visibility into how I am doing, and I find that I routinely consume less than the 500 mg general recommended minimums for sodium on those days when I abstain from eating pre-prepared whole grain bread.

          I do not find this to be particularly disturbing because 1) I feel great, and 2) I am falling well with the WHO the guidelines for minimum sodium consumption of 200–500 mg/day, ( )

          On those days when I exercising and as a result perspiring more, I find myself eating more pre-prepared whole grain bread consequently get more calories and sodium.

          1. I’m really curious how you could do that, unless you’re eating VERY few calories, or mostly fruit. Veggie-based SOS-free eating is going to put you in the 1,000 mg/day range on average. The 14-day meal plan I analyzed in the Bravo book contained the following amounts of daily sodium (mg), with no added salt or salty products of any kind:
            658, 1200, 1370, 501, 1479, 918, 399, 1943, 1284, 1191, 482, 1298, 527, 446.
            Only two of those 14 days were below 500 mg. Hmmm …

            1. I eat fruits, grains, greens, berries, beans made from scratch in a pressure cooker, vegetables, mushrooms, corn tortillas, whole wheat pasta, tofu, tomatoes, onions, garlic, etc, etc. I eat between 1500-2200/day depending on how hungry I am. I don’t know what to tell you. Perhaps, the CRON-O_Meter database under reports sodium content.

              1. Nope, I did my analysis in CRON-O-Meter. And all of the nutritional analysis software apps use the same underlying USDA nutrient database, so underreporting is a nonissue. Interesting!

                1. That makes sense. Why re-invent the wheel.

                  I have been eating a lot of Chinese Broccoli (kai-lan) as of late. For grins, I compared 5.5 oz. of kai-lan, spinach and Swiss chard and the sodium content was 10.9, 123.2 and 562.3 mg respectively so it makes a big difference as to which greens one consumes as to the sodium content.

                  1. Yeah, for sure. Our 1,943 mg day contained both celery root and chard. Here are some numbers (raw not cooked):
                    Chard = 967 mg per pound
                    Celery root = 454 mg per pound
                    Spinach = 359 mg per pound
                    Romaine = 36 mg per pound

                    1. Yeah, I remember the first time I had Chard after weening myself off of added salt. I was so surprised that I could taste the sodium in the unsalted steamed Chard. I never had before.

          2. For many years, we have climbed mountains carrying 40 – 60 lbs packs for a couple of weeks straight, and our backpacking food (aside from fruit) is 100% prepared and dehydrated at home, made from fresh vegetables and lentils, no sauces beyond what we make, and it has never contained any added salt. Never had a problem. This is how we eat at home, too. We never go out–everything is too salty.

            1. That’s good to know VegEater. I’m not eating the bread for the salt. I eat it for convenience and because I feel like eating a tofu sandwich stuffed with a lot of other vegetables and smeared with ripe avocado or peanut butter.

              I remember in during high school football training that there was a big bucket of salt tablets that they would encourage us to take supposedly to replace the electrolytes that we were losing from training. I tried them once, and it didn’t make me feel good so I never took them again. I just figured that just because they didn’t do me any good, perhaps, other people did better on them. Perhaps some people’s bodies are just better at preserving the sodium in their bodies.

          1. Thanks, Kim … my “very difficult” above was an overstatement. TrueNorth’s meals usually contained a couple of cups of cooked chard each day. You can choose other veggies and get a lot lower. I wonder, however, if that’s even necessary or useful, because i have heard that the SODIUM in whole, natural foods is not an issue; rather, it’s the SODIUM CHLORIDE that causes health problems. Does anyone know more about this?

    5. Yeah, I don’t use added salt but I still eat wholemeal bread and use soy sauce on my rice. Many commercial spice mixes also contain salt. So, after this video, it’s definitely time to review my diet again.

    6. I also am a big fan of that smoky flavor, and the bottled smoke doesn’t always cut it. I was buying those tiny little jars of smoked paprika but they were so expensive and sure don’t last the way I like to use it! Gotta plug one of my favorite guaranteed mail order sites for cool ingredients that I either can’t find around here, or can’t find for the price… I just ordered a bunch of stuff, among them a pound of smoked paprika for $9.99, I was paying half that for I think one ounce! Also, a type of smokey tea I read about that is supposed to be pretty flavorful in recipes…lapsang souchong. Looking forward to trying that out, especially for cooking my beans! I’m pretty sure it’s loose tea, but no biggie since I usually just pulverize it in the blender and use the whole leaf anyway.

      1. Tess: This is what Wikipedia says: “Smoked salt is an aromatic salt smoked with any number of select bark free woods for up to 14 days. The kind of wood used for smoking impacts the flavor, which can range from subtle to bold or even sweet. The most common choices are alder wood, apple wood, hickory, mesquite, and oak. Infused smoked salts like smoked bacon chipotle sea salt are very popular because of the dynamic flavor profiles.


        My guess is that you “smoke” salt just like you would smoke any other food product. The salt takes on some of flavor of the smoke.

    1. To really be accurate you should weigh your salt. Real bakers recipes use weight instead of volume because the chemistry of breads, pizza crusts etc are so critical. Grab a micro scale from an online store and then measure 5 or 6 teaspoons of salt and you will see how much difference there can be in weight, from the same volume of salt.

  6. Don’t know if anyone has asked already, but is salt reduction more effective than adding potassium in reducing hypertension? And why is flaxseed so good at reducing hypertension? Thanks

    1. I think to reduce hypertension you should consider sulfur, Magnesium, and Selenium. I am considering using Selenium the rest of my life for anxiety. I have days to enjoy everything you’ve done here.

  7. I don’t quite understand why the salt industry would care, only 6% of salt mined is used in food prep .. more, 8% is poured on our roads to keep them ice free, and most of the rest is used in heavy manufacturing? I got my bp’s down by eliminating alcohol and haven’t given salt or sodium a second thought, 60yrs. old 30 yrs. as a T1 and my pressure rarely breaks 100/65 anymore.

  8. I wonder if spikes in BP and other health problems have more to do with additives than they do with the salt? Think about it. As we take in larger quantities of salt with additives, we’re also taking in larger amounts of the additives. At some point, maybe there’s enough of the additives in our bodies to cause problems that smaller amounts might not cause? Maybe salt is getting a bad rap for what the additives are doing? Here’s a link to a list that might be interesting / helpful to consider – As much as possible I avoid salt with additives and go for just plain salt. Love food with the shortest ingredients lists!

  9. So I have been trying to work on lowering my blood pressure. When I eat at home and prepare my own meals I may be only getting 800- 1000 mg of sodium. Is it possible to not get enough salt. My blood pressure has not been moving downward that I can see.
    I should add that I am very active and at a normal weight.

    1. As I understand it, the human body is very dynamic when dealing with certain chemicals and recycles those that are in low supply when such is possible. If your sweat is salty, you have excess. In the dark ages (the early part-we’re still trying to emerge from the dark ages of nutrition) we thought that sweating “used up” salts. And took SALT TABLETS to compensate. Folks are only now beginning to “unlearn” this. Industry doesn’t care.

      I only sweat salty the day after I eat processed/restaurant/celebratory foods-which is infrequently.

      My mom’s blood test shows low sodium-BUT that’s a chemically induced condition from pharmaceuticals. She consumes a bit much of it.

      You may have Rx drugs causing interference, or maybe you don’t respond to the up/down salt and BP correlation. There are always exceptions. Like me. My BP couldn’t go down when I cut out processed foods as it would become too low to function and I would faint.

    2. For blood pressure, consider Magnesium, Sulfur, and Selenium. I also think I had a salt deficiency. Thank you for posting. Thank you for eating some salt. Salt may be a scapegoat.

  10. Great Vid, as usual.. copy/paste to all my Blood Pressure effected friends… I dole out my salt intake by taking 1500 mg and put it in a small saucer on the counter.. That’s my daily amount. A pinch here, a pinch there. I try to use less than what is in the saucer. I’m curious if potassium chloride raises BP .
    If not I could mix the Pot.Chloride and a bit of Sod.Chloride and cut the amount of Sodium in half!!!
    Also why does alcohol raise BP??? Vaso constriction?? I don’t think ETOH has sodium in it…

    1. Good question on Alcohol, but then I drink and have low BP. But in real life ETOH leads you straight to the salty snacks stand (mmm PRETZELS!!!). Also that’s why salty snacks are often free where ETOH is sold.

    2. I don’t, but I have notice that wine consumption will raise my BP, and that can lower my BP by abstaining from drinking wine.

      The American Heart Association (AHA) does not endorse alcohol consumption. In the “Myths About High Blood Pressure” the AHA states: ” If you drink alcohol, including wine, do so in moderation. Heavy and regular use of alcohol can increase blood pressure dramatically.” ( )

  11. What about measuring your blood pressure at home? It seems likely a highly hit-or-miss proposition, very inaccurate unless you take great care to do it right, have the right equipment, etc etc. And then when we go to the doctors we often have artificially elevated levels because — we’re scared we might be getting a finger up the butt, a shot, or whatever. And then the doctor scares you by suggesting that you might have high blood pressure under those circumstances, but suggests there are some great pills for that. I accept the warning here about blood pressure but I’d like to know if it’s not often taken a bit too far. (One other person in the plant diet field whom I respect Pam Popper suggests the whole salt thing is overblown. She’s on YouTube as well.)

    1. White/Lab Coat Syndrome is a common phenomenon, where mental state/fear elevates the BP in a subject.

      The best way to test/measure ANYthing is in such a way as you can achieve repeatable measurements. I’ve played with cuffs enough to see that body position has LOADS to do with it. One should start with a fixed position…like my old doc used. Same chair, same arm, same rest, every time. No matter where he found me wandering in his exam rooms (hey I look things over), he or his nurse put me into the same place every time BP was checked.

      Once you’ve acquired a good setup and repeatable (not exact but very close) measurements, THEN you can play with food, exercise, mindset, supplements, drugs, sleep deprivation…whatever you like in order to see what _your actual BP_ does in response.

      1. Sounds like a good plan. Anyway. Why do farmers put out salt licks for animals? I’m just questioning the assumption regard the deleterious effects of salt. Personally, I used it sparingly, but use it. And I depend on it for iodine. If you check Pam Popper’s videos on this, you might become equally sceptical.

        1. Why do wild (and domestic) animals converge on natural salt licks? It’s a necessary thing. Problem is we made it ubiquitous in everything all day long (more is not better, once again). Also, what farmers do to animals, well let’s just say that salt licks are the least offensive. Also, farm salt blocks come in a few different varieties of other supplemental minerals, depending on the “needs” of the stock. I put them out for the wildlife to enjoy and to view such.

          1. Good points. Anyway. That applies to those eating SAD. Here, we don’t eat like that. We don’t eat those processed foods. So, the basic question is whether we should be concerned about adding salt to taste or to absolutely minimize it, which is what this video suggests. What is better? Should we be REALLY concerned about it? And I’m only suggesting that people review what a very close associate of John McDougall named Pam Popper says on this subject. She has plenty of videos on her YouTube channel on this topics. So, how can we get such divergent opinions on this subject? It’s similar to Dr Greger’s rejection of white potatoes as unhealthy for us. There is a possibility that on a few subjects, Dr Greger simply has it wrong. I’m not saying this is the case with salt. I’m merely questioning this.
            Dr Pam Popper: Cancer Screening; Salt Intake,

            1. I watch Pam a lot. If you look you’ll see my comments sometimes. The reason salt to taste is wrong is that taste is VERY dynamic and can be shifted up and down without regard to needs. Of this and NaCl I’m quite sure.

                1. I’ll have to review her ideas on NaCl.

                  There is no doctor or nutritionists with which I agree 100.0%. Pam and Michael and I all agree on the preponderance of the evidence and the overall theme that: Eating more plants and less animal products almost always increases health and longevity. After that I’m happy to work out the finer details for myself and feel that others should to. I haven’t even read the new book yet…

                  I’ll try to remember to look at Pam’s salt commentary a soon as I finish the video she posted today on ADHD (with which I am diagnosed, which means I may become distracted before I do exactly that…). See how I ramble?

                2. Okay, I got carried away commenting on Pam’s video today. I get geared up when you’re talking about my brains. ;-P

                  I watched her speak to salt and the study that looked at high/high-normal/low-normal/low consumption of salt. I don’t disagree, because I know that my salt and BP aren’t linked as I’m told they are. Someday maybe we’ll understand this more.

                  My personal salt consumption is probably MUCH closer to Pam’s than Michael’s. Yep. Pretty sure about that. cheers.

              1. Exactly. Sodium satisfaction is an acquired taste. A long time ago I began eating less salt, and that’s still true today. When I go out to eat, I have to tell them “easy on the salt”, not for a medical reason, just because the food taste too salty. Although, there is an exception, tortilla chips & salsa,.. but that’s a rare indulgence.

                1. I have made my own tortilla chips (and am making tortillas tonight) such that I can eat more of them as I only use corn flour and water and bake the chips. Sometimes I add ground flaxseed. I eat plenty of salsa. Prefer to make it too, when the garden is making tomatoes. Salsa and chips with spinach, onions, black beans is “staple” meal for me.

                  1. Home made tortilla chips & salsa, sounds great, and I love black beans. One thought, unless it’s organic, or you know the source, corn is probably GMO. While science still debates its long safety, I personally avoid GMOs whenever possible, If for no other reason than to make a point with the money I spend.

                    1. Because industry owns our/the government/s, we cannot know what is/is not GMO, so I don’t fret over it. I don’t agree with it, but I’m not going to extraordinary lengths to avoid the crap either. I’m creating my own seedbank for gardening. Processed foods of wheat and corn have long been GMO, who knows what damage is being done. Indu$try don’t care, profit$ over people.

                    2. Completely agree with the first sentence, although I don’t believe wheat is GMO. As to corn & soy, unless it says “non GMO”, or organic, I just assume it is. Truth be told, I can’t keep up with how many crops are now GMO. Lastly, I’ve always said this, “people are under the illusion that we elect a government, or even that there is a government… when really, all there is are multi-national corporations the rule our lives and our planet.”

          2. I’ll take a guess. Because salt helps to hold water? And maybe it’s a way of self preservation especially in times when water is scarce? Here a bigger question, putting God & religion aside, if life originated from the ocean, and the ocean is what, 2/3 the earth, why is it so salty?

        2. I think it’s a threshold issue. Just because small amounts of something in the diet are essential or health-giving, does not necessarily mean that unlimited or very large amounts are equally healthy.

    1. Dasaniyum: Why do you do you think that sodium from miso would not count? It’s funny that you would say that today as I was just yesterday watching a video on youtube about this question. The video was an excerpt from a full length video by Jeff Novick, a well respected plant based RD. Jeff stressed very clearly that what matters is total sodium, not it’s source. And as an example, sodium is soy sauce is just as much a problem as sodium from table salt or processed foods. So, I would think that sodium from miso is very much an issue if the total sodium you are taking in exceeds the recommended limits.

      I’m curious though if you have reason to believe that miso would be an exception?

      Here’s that video if you are interested:

        1. Dasaniyum: Oh! I’m so glad you brought this up. I’m reading the book, but I haven’t gotten to that part yet. Your post got me to use the index to find what you are talking about. It’s on pages 280 and 281. So interesting! Thanks for the tip.

          I would wonder what synergistic effects miso might have with an otherwise high salt diet, but my musings aside: the findings for miso concerning stomach cancer and hypertension make me happy as several recipes that I like include miso.

          1. I’ve only tried adding miso to some sauces and soups that I make. What else do you add miso to?

            I don’t think Dr.Greger covered much about miso on this site. I wonder if he will make a video on this.

            1. Dasaniyum: Definitely sauces and soups. But also vegan nut cheeses and some casseroles and chili (which one could think of as a kind of soup and thus cheating to include as a separate category). Also, Dr. Greger’s 8 Check Mark Pesto recipe includes miso. It’s yummy. A whole party full of people agree with me on that one. :-)

                1. WFPBRunner: I’ve made two pretty firm cheeses from Miyoko’s book, Artisan Vegan Cheese. I liked them, but they were a lot of work. And I came to realize that the vast majority of time, I don’t want a firm cheese. I want a sour cream type of consistency that I can put a dollop of in a stew or spread on a wrap or cracker or to mimic a melty cheese in a sandwich or on pizza. So, I don’t quest for the hard cheeses. I’m happy with the soft ones.
                  While I haven’t tried making it, I’ll also mention that Miyoko’s new book, Vegan Pantry has a shaved “parmesan”. This one is interesting. It uses a technique I haven’t seen before. You end up spreading the stuff almost paper thin on silicon matts and baking. Then you “break into shards”. That phrase and the title of the recipe makes me think that the results are quite thin.
                  Two thoughts on the parmesan: 1) I would really like to taste this recipe, but I don’t know if I would want the work of making it (spreading to paper thin, doing three sheets, etc). 2) The recipe gave me the idea that maybe I could get a firmer block style cheese by following some basic recipe and then also baking it. Something to play around with maybe??? The texture may not work out, but I liked the idea of trying/inventing. I give anyone reading this full permission to try this idea as long as you let us know how it works. ;-)

                  1. Ok. I have Vegan Pantry so you have motivated me to give the Parmesan a try. My husband is a cheese guy. He actually really likes the soft “cheeses.”

                  2. I love Miyoko’s books! I am lactose intolerant and always hated milk, but cheese is a whole different “animal”! Going vegan, foregoing cheese was my only big regret, and some of the vegan cheezes were sad substitutes and infuriatingly expensive too. Over time I’d gotten used to the quick and dirty vegan options to make yourself, but Miyoko took it to the next level! Not only the flavors and textures, but that it is so much easier than dairy cheese to make yourself!

                    One thing that I didn’t see in her book though is something I love to make…oatgurt! Oats are cheap and healthy, and something I always have on hand, so was thrilled to find the option to make a kind of yogurt with it! I kind of toyed with the recipes I found online because they all used groats, and I only had old fashioned oats. I ground them fine first, soaked them for a while in water and soymilk, and processed again for a smooth thick paste that I added culture to, and proceeded just like regular yogurt. I think 5-6 hours later of being in the oven near the light, it was done. I used to use plain soymilk to make yogurt, but it didn’t always set up for me, came out like the drinkable yogurts, but oatgurt is more consistent and really easy! My next venture, thanks to your post, is to try to make cheeze with it!

                    1. Charzie: Outgurt sounds very cool. I can see how that would work since oats are so creamy. That idea reminds me of the cheese sauces that Julie Hasson did in the Vegan Casseroles book. Those sauces are a mix of cashews and oat flour. The oat flour adds a very nice texture.
                      Your post also reminded me that Miyoko’s Panty book includes a couple recipes for oat gelato. I just looked it up and that recipe includes a mix of cashews and oats also. The description describes it as the “next best thing to artisan vegan cheese” and “low fat”. It’s definitely on my list of recipes to try. Though I may wait until summer. Or maybe not…
                      Your idea of trying to make a vegan artisan cheese with oats really appeals to me. Please let me know how it goes. As the one who knows more about fermenting than anyone else on this forum, I’m guessing you won’t have any trouble making the rejuvalac. I’ll share that I have twice tried one of Miyokos artisan cheese recipes but substituted beans in place of the cashews. It totally did not work for me. The texture was fine, but I really did not like the taste. That surprised me, because if I had to pre-guess what the failure point would be, I would have expected it to be the texture, not the taste. I gave it a lot of thought and decided that the sweetness of the cashews is an important ingredient to making final product work. So ,the second time I tried my bean cheese, I added some sweetener and it was another gross mess that I ended up throwing out. I’m definitely not a chef. If you can get the oats to work, I’ll be very interested.

                    2. Yes, I use a yogurt culture and temps appropriate to the specific bacilli, but the recipes I’ve seen online seemed to just rely on spontaneous fermentation and warmth. One of these days I’ll try both and compare.

                    1. Cool! That cheese making sure is a lot of “hurry up and wait” steps. I can’t wait to hear how it comes out.

  12. I have a few issues with this video on salt. There is no mention of the types of salt i.e. processed/industrialized vs. natural unrefined — Himalayan, celtic sea salt, etc. I have read numerous studies (ex: that it is the TYPE of salt that matters. I was battling HBP for years (no drugs); then changed to a more plant-based WF diet, restricting my salt intake. My BP dropped. However over the past 1-2 years, I started using more salt – specifically Himalayan, approx. 1/2 teas+ per day; and my BP has not increased. So I feel there is validity to the type of salt used. I wish this would have been discussed in the video.

    1. Dear BChristine, Great, you brought a very interesting dimension to this debate of salt (white / table salt). Anyway, DrBrownstein’s 1.3 min. video clips that you posted does not say anything and just recommend to buy his book (not informative at all). Do you have any good reference for the benefit of rock slats or pink salt. Thanks a lot.

    2. As far as I know, all this stuff about the type of salt is just marketing hype. People making these claims are usually selling something and seldom refer to credible scientific studies – it’s usually only references to some web site or another by somebody else selling something.
      I’m curious – have you seen any credible scientific studies to support these claims?

      1. Yes, looks like my other comment was deleted …. I had two links which were much more explanatory than in my 1st comment; which mistakenly led to a webpage of Dr. Brownstein selling his book.

  13. Come on Doc, you know that what they calll salt is not really salt, Table salt (Morton’s) is an unnatural, adulterated industrial chemical which is toxic to humans. Real salt, sea salt has about 80 other minerals in it. That is what the body needs and craves. You ccannot have a dis ussion of what salt does to the body if you are are not using salt.

    1. Name 1 mineral that is found in real sea salt in nutritionally significant amounts. Name 1 adulturant in table salt and show that it is toxic at typical levels of salt consumption.

  14. Since I eat hardly any processed foods, I eat little salt in the diet besides vegetables, and soy sauce on veg bakes and the like. Other than that my salt intake is around the 1500 recommendation and sometimes may approach the 2300 guideline of AHA. My thing is, my cholesterol numbers are very low and I’m a very active and fit individual. I just don’t see blood pressure as a threat at all in my situation TBH.

  15. Very informative , I finally understand the mechanics of it i.e. the body trying to rid of excess sodium pushing up the BP.

    Now I am wondering , do I have to give up Miso soup as well ? Many brands contain additives as well so this is a concern.
    What would be the safe amount/bowl per week?

    1. vegank: If you have the book, How Not To Die, read pages 280 and 281. Miso soup may not be a problem! And it may be protective to have as much as 2 bowls of miso soup a day. So, I think you are OK on miso front. I can’t say anything about about the additives front. Maybe now is a good time to learn how to make miso soup?

      1. Thanks Thea, that is a relief. yes I do have the book, my glasses got mowed down recently (!) so I haven’t got as far as pp 280-281 … I make Miso soup from scratch (Miso paste), but noticed that some brands have the “added Dashi flavor” i.e. additives. Fortunately they label them, so one can tell. The brands that are marketed for the restaurant owners /industrial use is actually better, as they do not add too much of the Dashi powder. (you may know that natural Dashi is stock made from Konbu & dried bonito flakes). Good news anyway : )

        1. I’m not to that page yet either. :-) Another poster brought up the miso question just before I saw your post. I had just looked it up. One of those galactic coincidences things. Well, sort of…
          Thanks for the Dashi info. That was new to me.

          1. I thought you would’ve read the book twice by now !
            Traditionally, the Miso paste was added to the clear golden brown Dashi/stock. The Dashi gives more flavor and depth to the flavor without adding salt at all.
            But then the “Dashi powder” was invented ( I think in the 60s~70s).
            So the new Miso with “added Dashi ” came next. I don’t know if it contains MSG, but I react badly to them and always buy the Dashi-less Miso paste.
            Now you’ve given me an idea , making your own maybe a better way to avoid additives .

            1. I usually make a bimonthly trip to an Asian grocery near here to stock up on many vegan items that are hard to get or much pricier elsewhere. They have a great variety of miso, even non-GMO, tofu, exotic produce, canned goods, jasmine and other rice, a variety of glass, soba, and rice noodles, even fresh noodles, green jasmine tea, bulk seeds, fermented black beans, and on and on! Since I was a seafood lover, I am more than ever a huge fan of sea vegetables, better known as seaweed, of which they also have a nice selection! I often make a vegan dashi stock with a variety of them and add the miso to that for a more authentic flavor. (Just remember to wait a while so the stock or water can cool a bit before adding the live miso to retain the enzymes and probiotics that make it so healthy)!

              1. It’s funny how Tofu is so expensive (and tiny) at the supermarkets , but at the Asian grocery stores you can purchase all the different variety (Silken, Hard, Seitan etc) for 1/2 the price made locally. I don’t know if it can be backed scientifically but my grandmother used to say that Sea vegetables are good for healthy /shiny hair, and she had far less grey hair than her friends who dyed theirs. I did not know about the enzyme and probiotics, that’s good news! Have you tried Kon-nyaku (spelled Konjack in Western countries)? It’s made from a kind of Japanese mountain potato , dark grey in color , shaped and packaged like Tofu. It is great with vegetables simmered in Dashi stock, quite filling. Another very nice stock can be made from soaking Dried Shiitake mushrooms with warm water, but I am not sure if they are toxins /pesticide free nowadays and have not tried them.

  16. Shouldn’t any discussion on the effect of high sodium on the body take the potassium level into consideration? Since plant foods are rich in potassium, a comparison between a cohort of WFPB eaters consuming little added sodium to one of WFPB eaters consuming a lot of added salt might shed light on this issue.

  17. Good Morning all, I am wondering if sea salt or high nutrient salt (pink salt or celtic sea salt ? has the same effect. Were the studies conducted on the common process salt of the western diet or naturally forming salt as well with all of its goodness ?

  18. Canned soup, OMG! Even the “lower sodium, heart healthy” brands are outrageously filled with salt, as much as 850 mg./ serving! Eat the can (2 servings), which isn’t much, and you’re at 1700 mg. in just that bowl of soap, exceeding the recommended daily allowance for the entire day. With that much salt, you can use it to melt ice. I know, make your own soap, which I do when I have time. Still, I always have a few cans in the cupboard.

  19. Since going vegan, I’ve had some dizzy spells which I think are due to low blood pressure.. I’ve always had somewhat borderline BP, and last time I went in it was 150/90 (usually it’s around 130/75). Should I be upping my salt? I have to go see the doctor, but I absolutely hate going.. ;)

      1. That’s amazing that you can tell that. I haven’t been tested since going vegan so I actually have no way of knowing. :/ The dizziness is a clue, though.

    1. Think before you follow advises blindly. Salt intake depends on many environmental factors other than food (spice). It is the most abundant electrolyte (NaCl) for a reason. When people are dehydrated, they are put on 0.9% salt (IV bag). If the brain neurons go dehydrated, people can go into coma. Google it.

    2. I’m with you, going to see the doctor is associated with more negative outcomes than positive for me, and staying away in good health is a much better option than the inevitable prescription for something I didn’t even need! My BP is usually around 80/60 and have no symptoms, so not sure what you would consider low BP? Besides monitoring it yourself to find the #’s though, if you are worried, it might warrant a visit for peace of mind?

      1. Yes, I get bad anxiety going which drives my BP up. One time they put me on BP pills and it made it so low I just about passed out while standing up, because I think it’s pretty normal when I’m not anxious. I have to go back in soon anyway, so I’ll see what improvements have happened since going vegan. :)

  20. Oh goody, no salt! I’m just now figuring out that Whole Food, Plant-Based is even more restrictive than vegan. It means no oil, no sugar, just what you would eat if you were a bunny rabbit living in the wild. Is anybody doing this??? How Not To Die says to list 3 WFPB meals that you already eat in order to get started. I couldn’t think of one. I even put coconut milk on my oatmeal. Is that ok? Or does it raise my cholesterol? And what about the 2010 meta-analysis compiled by the Journal of Clinical Nutrition that found “There is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of coronary heart disease, stroke, or cardiovascular disease.”? Why does my doctor and Dr. Greger say I need to lower my cholesterol if that is true? Why is there such a difference between the diet recommended by 2 Nutritionists in It Starts With Food and Dr. Greger’s recommended diet? Aren’t they using the same info? I am so confused.

    1. The dairy, meat and egg industries want you to be confused. So does the Atkins Diet empire. They make money from selling high saturated fat foods. They are also very active spending money on scientific “research”.

      The notorious 2010 meta analysis published in a reputable journal simply looked at people who ate high levels of saturated fat and people who didn’t. It’s one of a number of recent studies doing the same thing. In Western societies, people who eat less saturated fat usually eat more white bread, trans fats, and junk food generally instead . It’s no surprise therefore that both groups are equally unhealthy. However, experiments where the saturated fat in people’s diets was replaced with less unhealthy alternatives like polyunsaturated fat show that mortality goes down as saturated fat consumption goes down.

      The fact is that observational and experimental studies show that high saturated fat consumption increase the risk of diabetes and cardiovascular disease. And research has identified the ways in which saturated fat damages arterial health.
      But endothelial effects aren’t the only way, saturated fats (SFA) affect cardiovascular health. This table summarises a range of effects of SFA on atherosclerosis (compared to omega 3 polyunsaturated fatty acids). None of them suggest SFA in large amounts is heart healthy.

    2. I’ve been WFPB for 25 years and it is hardly restrictive. There are so many fruits and vegetables and grains and beans to try. I consider my diet quite varied and not at all boring. I’m not sure what bunny rabbits eat other than lettuce? Last night I made a vegan lasagna, no oil, no animals, no fat, no dairy, no soy. It is so good and it’s a hit with my meat-eating friends!

        1. Linda: I hear you on that salad dressing. But FYI, I’ve tasted some truly fabulous salad dressings that just happened to be oil-free. We are talking first class where you don’t miss the oil At All. If you are interested, here are some ideas:

          The first link, in addition to a recipe, gives tips on how to convert an oily salad dressing into an oil-free one:
          > Fat Free Vegan, Buttermilk Dressing:
          > 10 Simple Recipes:
          > Magical Recipe:
          > There is also a great oil-free recipe in Dr. Greger’s How Not To Die book

          If you try some of these recipes, let us know what you think. We know that you have high standards. So, a thumbs up on a recipe from you will really mean something. Hope this helps.

        2. I also like the Caesar dressing at Straight Up Food website, a website that Dr. Greger recommends in his book. Another one that the meateaters really enjoy, they all think it tastes like the “real deal.” Serve with mixed green salad and … vegan lasagna. :p

          My most frequently used salad dressing is that 123 dressing I think it’s called? I think it’s a Mary McDougall creation, you can make as much of it as you like with the ratios, but I make single serving sizes for salads almost every day. The ratio is 3 parts vinegar, 2 parts mustard, 1 part sweetener. A single serve for me is 2 tablespoons balsamic or pineapple vinegar, 1 tablespoon grainy mustard, and 1-2 teaspoons vegan sugar or maple syrup. So good and very easy! Guests like this one too. :)

    3. The info is so contradictory because there is huge profit to be made from our ignorance. This is a great place to get educated about reality, not marketing! No conflict of interests here…see any advertising or pushing of products? Dr G cares about people, not $$$! Any donations he does get go to charity.

      And no, I don’t find this way of eating restrictive. Granted at first it was a bit intimidating because it was so different, but there are worldwide cuisines with a huge amount of plant based recipes all over the internet, once you know what to look for! Just imagine there is no processed garbage, as we have evolved with the food that grows and is available naturally. It can be a simple or as complicated as you please, but rabbit food it is NOT, don’t limit yourself by that outlook. The rewards are so worth it! Future benefits aside, compared to the way I felt before, I just wish I knew earlier about WFPB instead of the diet BS that circulated as fact! What WAS limiting was counting, weighing, measuring, portioning, breaking everything down into categories, and relying on willpower. Eating all I want of whatever grows isn’t just a lot easier, but a lot healthier too, physically and mentally. It IS a learning process but guess who reaps the rewards?

    4. It’s contradictory because diet and its interaction with the body is hugely complex, as well as highly individual. The result is that some research will tell you salt caused high blood pressure in the test subjects, and then someone will extrapolate that to the whole population. Another piece of research will find that their test subjects did not develop high blood pressure, and just as wrongly someone will extrapolate that to the whole population. The same goes for other things.

  21. After reading about salt in an earlier Dr. G video several months ago, I went from putting lots of salt on everything to eating less than half a teaspoon per day. I don’t miss it. I find that cider vinegar is a great substitute for the tang I used to get from salt. Try it on your next plate of steamed broccoli!

    1. Freshly ground black pepper works great as a salt substitute. I’ve also used Table Tasty, which I believe has vinegar in it? It’s very tangy and much better than those Mrs. Dash flavors.

  22. Not sure if this is the right place to ask.

    If I was a soon-to-be 4th year medical student interested in learning more about nutrition and lifestyle interventions in my fourth year who should I contact? Any opportunities?

    The McDougall program accepts 4th year med students to intern with their live in program, but aside from that I haven’t heard that much.

  23. Or you can put kombu into your soy milk and give hundreds of people iodine poisoning, as Spiral Foods did in Australia. Kombu gives the salty flavour but avoids the sodium listing requirement, and sounds healthy. BTW, that ended in a class action against the manufacturer, which ended up winning.

  24. Will someone please let me know if salt is necessary for a healthy diet and if so is sea salt (natural salt) healthier. I’ve just read to many negative things about table salt.
    Thanks for the info,

    1. That’s a fair point. Maybe they should add potassium to salt? Then again, that’s like saying we should give aspirin to those who bang their heads against the wall…. Just eat less salt.

    2. This study found a 41% reduction in CVD mortality from reducing sodium intake 26% to 3.8 g (still high by AHA standards), while increasing potassium intake by about 76%:

      Chang HY et al. 2006. Effect of potassium-enriched salt on cardiovascular mortality and medical expenses of elderly men. The American journal of clinical nutrition, 83(6), pp.1289-1296.

      Five kitchens of a veteran retirement home were randomized into 2 groups (experimental or control) and veterans assigned to those kitchens were given either potassium-enriched salt (experimental group) or regular salt (control group) for ≈31 mo. A significant reduction in CVD mortality (age-adjusted hazard ratio: 0.59; 95% CI: 0.37, 0.95) was observed in the experimental group. Persons in the experimental group lived 0.3–0.90 y longer and spent significantly less (≈US $426/y) in inpatient care for CVD than did the control group.

      Many studies have concluded that the potassium:sodium ratio has more influence on outcomes than absolute sodium intakes. I moderate salt intake (though not to AHA levels), but reintroduced potatoes and other tubers as staples (it’s difficult to consume the recommended 4.7 g K without favoring tubers as starch staples over grains). It shouldn’t go unnoticed that traditional communities that have negligible hypertension aren’t just consuming low sodium, but also high potassium from staples like boniato, breadfruit, malanga, plantain, taro, and yuca.

        1. Always better from food.

          Potassium salts in pill form can cause small-bowel lesions narrowing the gut, sometimes causing ulcers. Since 1975, the U.S. FDA has required a long warning label on supplements containing 100 mg or more potassium, so non-prescription potassium supplements in the U.S. all have 99 mg

          While tubers are the starchy staple with the highest potassium, other foods have more potassium on a weight basis:
          Dried fruit: dry packed sun-dried tomatoes (34 mg K / g !), apricots, prunes, raisins (8-12 mg K / g), tomato paste (10 mg K / g)
          Bran: Rice bran, wheat bran, All-Bran cereal (10-14 mg K / g)
          Seeds / nuts: pistachio, sunflower seed, flaxseed pumpkin seeds, hazelnuts, peanuts, almonds (7-10 mg / g)
          Other: Palm hearts (18 mg K / g), dry roasted soybeans (14 mg K / g)

          Rather than potassium salt pills, consider keeping dried tomatoes about. I keep bulk vacumn bagged Turkish sun-dried tomatoes (As low as $3.89/lb from here, or 2.5 ¢ / 99 mg K), which is not much more than the cheapest potassium citrate pill (1.4 ¢ / 99 mg K), and well worth it.

          1. Darryl: Great information as usual. Thanks!
            You are the second person in a short time to recommend the site. I took a look at those tomatoes you talked about and I’m definitely getting me some of those!

  25. It was revelation to me how quickly one could start feeling better after making the transition to a fully WFPB diet. What I wasn’t expecting is that when I strayed from that eating plan how quickly I would suffer the consequences.

    Without meat and oil, I noticed that my sodium consumption started to rise in an attempt enhance the flavor of the whole plant foods that I was eating. It didn’t make me feel good so I made the decision to ween myself off the added sodium once and for all. I gave away all of my canned food and pre-prepared sauces with added salt. I threw away a large container of white miso which I was using as a cheese substitute for pasta sauces, and I started adding lots of garlic, chilis and lemon juice to my food.

    Before too long, I no longer missed the added salt, and I felt even better which really surprised me. I got to appreciate foods for the flavor that they naturally possessed. Now, when eat in a restaurants which I am required to do for professional reasons, I will occasionally feel just terrible after eating what to me is heavily salted and oiled food, and that is after giving detailed preparation instructions.

    You can probably imagine just how much fun it is to go out to restaurant with me. ;-)

    After a particularly bad outing, I will spend the following day water fasting so I can purge the excess salt out of my system. I have become very sensitive to sodium. I can feel its negative effects almost immediately, and I don’t like it. When you grow accustom to feeling great, you have little tolerance for things that diminish that feeling.

    1. NIce work! I don’t even stray off the reservation, as it were, when I eat in restaurants. Many chefs are happy to accommodate my requests, probably since it gives them a little creative license. I’ve had some awesome veggie and grain dishes placed in front of me at some restaurants. Plus I’ve learned to cook WFPB dishes that my friends love (and request!), so they eat over here frequently as well.

      Eating out with friends is about the camaraderie and the company. Your friends/loved ones will love you no matter what you eat. You could sit there with a glass of water and you will still be loved! :p

      “I love that it takes you a half an hour to order a sandwich!” — Billy Crystal, “When Harry Met Sally”

      1. I love San Fransisco. Alas, not every eatery across the continent achieve or even aspire to the standards of those establishments that you choose to frequent.

    2. I so agree! I almost never eat outside my home, and when I can afford to, it is not the kind of place where special orders are an option! lol I try my best to at least stay vegan, but avoiding the fat and salt is a bigger challenge, and I will pay for it! I guess there is a benefit though because it always serves to reinforce WHY I choose to eat as I do!

      1. One of the benefits of traveling on expense account is that one is free to try all kinds of really tasty vegan restaurants so I’ve been lucky that way. It’s nice to have a meal with mock meat once in a while. I travel so much that many times, the last thing I want to do is eat out, and I will skip meals on the road, or I will buy some simple fare that I purchase at an organic supermarket.

          1. Yes indeed. I will occasionally entice a customer and/of co-working to give a vegan restaurant a try, but very often, I will find myself at a “meat market,” customer’s choice, so I have become adept at navigating the menus, and creating vegan friendly options from the sides on offer. I find fish restaurants the most challenging. Probably because they already consider themselves the healthy alternative. If the only knew. ;-)

  26. I’m WFPB for a year now. I avoid processed food and do not use salt. I eat out VERY rarely. My blood pressure is pretty normal at home 140/80. I wish it was lower. At the doctors office it soars! 181/95 today. I shouldn’t be able to get it this high! What else could be driving this? I want lower bp. I’m 5’6″ 135 pounds.

      1. As the link says there can be problems that cause elevated BP that salt intake won’t change. One is nerve damage that affects the sympathetic nervous system or anything else that messes with that system. My problem is nerve damage and migraines. But I still don’t use an excesses of salt as am no longer used to it.

    1. Are you overweight or a minimal exerciser? Both of those contribute to HTN. If you’re overweight and still losing on WPFB, your B.P. could still come down. If it were me, I’d probably follow the Daily Dozen template for a few weeks and then recheck.

  27. For those people who have been asking about Himalayan salt or sea salt, I think Tom Goff came up with a good answer/link. I remember another great answer from Darryl from a couple of years ago. I’ve been looking for it for a long time and finally found it again just now. I think the following answer is also helpful for the topic of salt types/origins/processing.

    and here is a follow up post on the same topic

  28. i dont use aded salt at all, so my diet has about 150 mg of sodium per day. Some sources say that its not enough and for optimal health its needed to consume about 1700 mg of sodium per day. Do I need to eat more salt to be healthy?

    1. Interesting question. The answer probably depends upon your body size, the level of your daily physical exertion and the climate where you live. The UK Scientific Advisory Committee on Nutrition’s report on “Salt and Health” commented (p23):

      ” Lowest average intakes of sodium consistent with apparent good health, in individuals or populations, have ranged between 69-920mg/3-40 mmol per day (1.75-2.3g salt) (DH,1991) and populations surviving on as little as 5mg/0.2 mmol sodium per day (0.01g salt) have been reported (IntersaltCooperative Research Group, 1988)”

      The Australia New Zealand adult Adequate Intake (AI) for sodium is estimated at 460-920 mg daily so yours would definitely be on the low side if your estimate is correct. However note that there is a lot of “hidden” sodium in animal foods, breakfast cereals, ketchup, bread, canned vegetables etc

      1. well im 30 y old male, my BMI 23, im doing 30 min aerobic training every day and 1 hour weight training 4 times a weak. I eat only whole plant foods, or making dishes myself out of whole plant foods, i eat no animal foods, no processed meals or meals that are not made by me at all. Thats how i know im getting around 100-200 mg of sodium every day (it comes only from plants). I’ve read some articles which say that if you not get enough sodium (about 1500 – 1800 mg for my age and body mass group) there could be some pretty bad heart problems. And i noticed that only then when im not having any added salt in my meals , my blood pressure device shows that i have irregular heartbeat. SO after all i gues I should add about 7g of salt in my meals everyl? do I?

        1. Carl: I’m curious if you use cronometer to figure out your sodium intake? Or something else? (ie, how do you know sodium is only 100-200 mg?) Your post is interesting, because it seems to contradict what Laurie Masters (for example here: and here: has posted about her research into the sodium content of whole plant meals. I wonder if you are just eating at the low-sodium end of the plant spectrum? Or maybe your numbers to calculate your sodium intake comes form a different source?

        2. Hi Carl. I’m no doctor so I can’t advise. However, dietary salt is essential and according to that Australian New Zealand paper. you do not have an adequate intake.

          I eat whole meal bread, oats and use soy sauce on rice etc. That provides me with adequate sodium. Adding a handful of olives daily to the diet also boosts sodium intake because of the way they are processed (in brine). You could also consider using canned beans or vegetables because they usually have salt added.

          If you decide on added salt, you need to remember that it’s necessary to eat about 2.5 grams of table salt to consume 1 gram of sodium. You may also want to consider using potassium salt instead of ordinary salt (it contains potassium as well as sodium). However, consuming too much potassium can also be risky. It’s probably best, though, to discuss your problem with your doctor.

  29. I realize that I’m looking for a loophole here, but sometimes I want to indulge in salty foods. Would it cancel out a handful of pretzels if they were eaten while drinking a couple of glasses of water? Wouldn’t that extra water counterbalance the sodium and let me flush it out – so to speak?

    1. As you cut back one finds less and less salt to be necessary to enhance flavor. I don’t ever feel deprived of salt (or anything), but consume quite a bit less than SAD eaters. I find our tolerance/desire for salt to be very dynamic. I still enjoy very salty foods, but not nearly as often as I used to.

      1. I have also found that to be true, Wade. On the other hand, I go to a lot of non-vegan parties and events. It’s often easiest to avoid meat and dairy laden foods by steering toward pretzels, salsa and hummus. (Raw veggies – even if they’re offered – get tiresome after a while.) Sometimes I bring a dish to share, but can’t always manage that.

  30. Great report, but what about “Sea Salt”? I’ve been told that sea salt, with its inclusion of many other minerals besides NaCl, is actually a good thing to use. Does this have any basis in fact, or is it simply marketing?

    1. The typical composition of seawater by dry weight percent includes: 55.5% chloride; 30.8% sodium; 7.7% sulfate; 3.7% magnesium; 1.2% calcium; 1.1% potassium ( )


      So sea salt has less sodium, although, since it also tastes less “salty,” one may find that they use more.

      1. Joe, actually halite has a number ratio of 1 chlorine atom to 1 sodium atom rather than an equal weight ratio. The atomic weight of chlorine is 35 and sodium is 22. Thus in 100 g of table salt there is 37.14 g of sodium, while in 100 g of sea salt there is 30.8 g of sodium or about 17% less sodium. So while the percentage of sodium in sea salt is less than pure halite
        it isn’t the nearly half as much that it might appear with we look at
        the 55.5% chloride to 30.8% sodium ratio as if it was ratio between the
        number of chlorine ions to the number of sodium ions. Sorry, just the math and science nerd in me coming out.

    2. I would like to know also, I’ve been using it because I bought some to use in my ferments. You aren’t supposed to use iodized salt and the minerals are supposed to be beneficial to the cultures and in the end of course, whoever eats it. I got a good deal on pink Himalayan salt, so have been using that. It’s hard to separate the opinions from the facts though, not much real science about it.

      1. I use Bob’s Red Mill sea salt. Before that I was using Eden. They have less sodium per teaspoon than a lot of the other sea, pink etc. salts. I like that.

  31. Silly question maybe, based on some of the things we eat, but curious to hear thoughts or opinions on why do you think we seem to crave salt, unless we make a very conscious effort to reduce it? it seems to be fairly universal and why food manufacturers include it in everything along with fat and sugar. I get that in nature the preferential taste for fat and sugar are associated with calories for energy and survival purposes, but what about salt? It seems the variations are wide in preferences and tolerances too…I know people who make it “snow” on their food, some with and some without higher BP, and others who abstain with the same variations in BP. I pretty much fall in the middle, have reduced even that, but there is a limit beyond which I just crave it. I know there is more to the picture than just BP, but my BP is fine to low, usually around 80/60. Curious also why it seems so variable in populations, and what might be the origins of the variations?

    1. Probably a combination of factors rather than one thing. Research is too good at reductionist thinking. And it may be a different combination for different people since we are not all from the same cookie cutter.

    2. When our biology was busily evolving salt would have been very difficult to obtain. In this as in every behavior we are ruled by the Motivational Triad of maximizing pleasure, minimizing pain and minimizing effort/cost. Since it is most likely that we obtained the large majority of our calories from plants which are naturally very low in sodium, we likely evolved such that salt tasted good (and so gave us pleasure) to give us the motivation to make the effort to find food that had more than average amount of sodium (including animal flesh, which might explain hunting as well or better than a quest for protein) or to eventually do more technological things like evaporate sea water or dig out natural salt deposits. But as we know we are now played foul by our natural preferences since now all the effort required to satisfy our desire for salt to reach for the salt shaker.

      1. Thanks Jim, that motivational triad is a biggie and can totally backfire on us! Still not sure WHY we require the salt if it is so rare in the food supply, but on reflection, I suppose that has everything to do with our oceanic evolutionary origins. I LOVE Doug Lisle and his wry humor, he’s quite the genius at communicating critical info in a way that entertains as well as informs!

        1. Charzie, you might be interested to know that the salinity of our bodies is very close to the salinity of the oceans at the time that our ancestors climbed out and started living on the land. In the millions of years since continued erosion has resulted in the oceans of today being much saltier. So in a very real sense we carry an echo of that ancient ocean around inside each of us.

          1. I grew up on the coastline so maybe even more than others I am totally tied to the ocean, it IS my blood. I think growing up I spent as much time in as out of the water. I don’t like being away from it, I feel cut off, isolated, like I am still part fish. When I was little, I was actually told by a pediatrician that I had the remnant of gills, a small hole in front of my ear, that is actually called a preauricular sinus. But apparently our ears are evolved from the same structures that gills shared, so who knows! Glub glub?

  32. So much bollonni for salt! It’s curious how we love to be taken away from the big truth. Our diet is compromised by a mixture of weird food products/chemical/fat and animal hormones that clogged every inch of our arteries, instead of asking our government “what have you done to us? ” What made us deserve the title, “The obese Americans”, we are bringing salt as the culprit. Well, whether you eat salt or not, clogged arteries create pressure. What is so difficult to understand? Salt is not good for people suffering of high blood pressure. Just like shrimps are not recommended for people suffering of cholesterol. However, in healthy people, salt does not make blood pressure rise and shrimps do not make you develop hypercholesterolemia. But once you have those health concern, you have stay away for certain foods.

    1. I wouldn’t assume that just because excess sodium and cholesterol consumption/levels doesn’t cause immediate negative impacts in nominally healthy people. Our bodies are actually pretty good at compensating for excursions from a healthy diet. But keep it up too long and eventually you end up having to pay the piper.

      It is always easier to prevent than to heal.

  33. Just thought I would bring up the subject of iodine. Iodized salt is one of the few reliable sources of iodine in this vegan’s diet. If I were to cut out salt entirely, I would have to find other sources.

    1. Not disagreeing or anything, but if you and others are interested, I just did the calculations to see if you can get enough iodine from iodized salt. According the the Salt Institute, iodized salt in the US has potassium iodine added so that ratio of iodine to total weight is 0.000045 to 0.000077. The daily requirement for iodine for adults is 150 mcg (millionths of a gram). So for a 100 g of salt there is on average 0.0058 g of iodine or 5,800 mcg. So to get all of your daily iodine from iodized salt you would need to consume 100*(150/5800) or 2.6 g of salt. For a given amount of salt 37% is sodium, so 2.6 g of salt works out to 0.96 g or 960 mg of sodium.

      The American Heart Association recommendation is 1500 mg of sodium a day. So if iodized salt is ones only source of iodine, then making sure that about 65% of your salt is iodized should do it. The trouble is that most packaged foods (where most Americans get 75% to 90% of their sodium) don’t contain iodized salt. So unless you are getting most of your sodium at home, you can’t depend on getting your necessary iodine along with your sodium.

      On the flip side you can get too much iodine. The upper limit for adults is given as 1,100 mcg. If you eat a lot of sea vegetables, especially, brown ones like kelp and kombu (which can contain 1,300 to 1,500 mcg per gram) then be aware of how much you are eating so you don’t OD.

      1. Thanks, Jim, for the careful calculations. I’m now confident that I get enough iodine from the small amount of iodized salt I put in my smoothies. I avoid processed foods as a rule. My concern was for someone who decided to eliminate iodized salt altogether, Amazonian Indian style. To put it in perspective using my own diet, navy beans (the food I eat that contains the most iodine–I don’t regularly eat sea vegetables) contain about 32 mcg of iodine per half cup uncooked, or about a third of the RDA. I very well might not make the RDA without the added table salt.

        1. A little more information. I looked up the half life of iodine in the body. According the Los Alamos National Laboratory, who is worried about how long radioactive iodine from nuclear bomb blast will stay in the body, the half life of iodine in the thyroid is 80 days and the rest of the body about 12 days. About 30% of absorbed iodine is taken up by the thyroid, 20% is quickly excreted and the rest is absorbed into other tissues. So since there is a relatively large range between the minimum and maximum amounts in a day and once absorbed it stays around for a long time it should be possible to eat just a small amount of kombu or kelp once a month or so and get all of the iodine you need. Kombu is said to help beans to cook quicker and taste better by adding an umami flavor. One of the brands of organic beans added kombu to all of their canned beans, but I believe they stopped because of concerns about people getting too much iodine if they ate a lot of beans (like many of us do). But if you add it yourself, you should be able to control the amount of iodine.

          But like you said, a not unreasonable amount of iodized salt will give you the amount of iodine you need without excessive sodium intake, as long as you aren’t getting non-iodized salt from other sources.

  34. If I eat only fruit for a meal I will urinate every 10-15 minutes for at least 2 hours following the meal. I figure the rise in water from the fruit enters and dilutes my blood which lowers the sodium to volume ratio. The posterior pituitary gland attempts to correct this imbalance by releasing antidiuretic hormone which prevents my kidneys from reabsorbing fluid and so it flushes out of my system. The negative feedback mechanism thus allows the added volume of water in the blood to reduce in order to regulate the sodium proportion. Clearly this is very inconvenient and not a diet I can adopt in a normal day job. If I were to include some salt with the fruit the diluted blood would equivocally concentrate and the posterior pituitary gland would not release antidiuretic hormone and the kidneys would return the fluid to the blood. More fluid in the blood means higher blood pressure.
    I noticed the older brother on “Sweet Natural Living”, who is a fruitarian drinks coconut water at least every morning. Coconut water does contain sodium and I’ve wondered if drinking it daily on a fruitarian diet might be an alternative, for me, to supplementation with salt? Dr Greger has described coconut water as a neutral food that is neither healthful nor harmful so maybe this could work? I figure I’ve missed something though and am a bit confused. If I manage to find living foods that contain sufficient sodium to prevent my excessive urination, how do I then prevent raising my blood pressure or becoming fluid retentive? I would love to gorge on fruit for each meal because fruit is so delicious but until I figure out this urination thing I’m at a loss. Does anyone have any ideas on my predicament? Are my conclusions about the sodium/blood/kidney relationship logical or am I missing something? Could it be that since I am new to veganism and still overweight that my system is somehow not accustomed to the dramatic increase in living foods and for some reason is causing me to urinate in an attempt to flush out years of built-up toxins?? I have so many questions. If anyone can offer some insights I would be grateful. James

    1. James: I don’t have an answer to your exact question. Instead, I’m wondering why you want to eat only fruit? A fruit-only diet is not recommended on this site or by any of the experts that I follow. My understanding is that a fruitarian diet is the hardest of the raw diets to do and still meet nutrition needs. I know that fans of the fruitarian diet disagree, but I don’t think the evidence backs up their claims. For example, check out the following site which shows protein needs and how much protein we can get from fruit as a category. It’s possible fruit would meet the needs, but it’s awfully close.

      As Dr Greger has shown, eating a lot of fruit can be very healthy. But eating only or mostly fruit??? If you switched your goals to a diet more like the one that Dr. Greger recommends in his daily dozen or PCRM with their power plate:, then I’m thinking you wouldn’t have your problem to begin with. What do you think?

      I have some suggestions for losing weight the healthy way if you are interested.

      If that answer doesn’t satisfy you, I hope that others will jump in with ideas for you. Good luck.

  35. There’s no manufactured controversy. There’s a genuine controversy because the facts are that salt’s impact on blood pressure for most people is quite small and short-lived. There’s controversy because anti-salt activists have tried to extrapolate the effects of salt on those sensitive to it to the entire population. There’s controversy because the real problem seems to be imbalances between potassium and sodium rather simply excess sodium.

  36. In my case, not using any salt at all, caused me some troubles. But, truth be told, I do have low blood pressure now since I’m vegan (I used to have high blood pressure when I was an omnivore) and I also exercise (sweat) a lot.

    1. Thanks for your question!

      In the athletic population, absolutely yes! “The range of individual sweat sodium losses during exercise is extremely large. Unless sodium restriction has been recommended for a particular athlete for health reasons, athletes should liberally salt their food and consume sports drinks that provide needed sodium and other electrolytes” (1).

      Hope this answer helps!

  37. I watched this salt video a few days before I went to a raw/vegan restaurant. The items we tried were all delicious but my salt sensors clued me in that salt had been added. The waitress explained that they do add salt because most people who come to the restaurant as an introduction to vegan foods, and they are used to saltier food. That is sad for the clientele who might be hypertensive. I also noticed that many of the items on the menu were concoctions that were plant-based simulations of non-plant-based foods like cheese dip or seafood, etc., and these are typically salty in the original version. I understand that this might be appealing to people who yearn for their old favorites, but I have pretty much divorced myself from my old food loves and I’m lovin’ the foods I’m with.

  38. Hi Dr McGregor
    My husband has high blood pressure. We have been on a vegan diet for over 9 months. He was doing great for 6-7 months. Then suddenly he has checked his blood pressure last month and he is showing 130something over 80 to 90something. We had cut out most processed food except organic chips. We cook most of the time so we dont add sodium to our meals. He doesnt like exercising much except walking. And when he walks he doesn’t do vigorous walking. I am at a lost for what else to do.

    1. Linda: I don’t know if this is relevant to your husband’s situation or not, but it is my understanding that weight is also associated with blood pressure. If your husband could use some weight loss, then doing so might help the blood pressure situation.
      I have some tips for weight loss if you are interested.

      1. Hi Thea, I know your response was to Linda and her husband. I am also in a similar situation and would love to look over your tips for weight loss, if that is okay. I love reading thru the comments to gain more knowledge and ideas! I hope things are moving in a positive direction for your husband, Linda. Thank you ladies!

        1. PAbbott: My pleasure! I’m going to assume from your post that you already understand about the importance of a whole plant food diet and have at least a sense of how to implement it. That’s half the learning curve. The other half is understanding the concept of calorie density and how to apply it to weight loss so that you don’t get hungry and you still get all the nutrients you need.
          Dr. Greger covers calorie density ( ), but not in enough detail in my opinion for someone who wants to apply it for the first time. Doug Lisle, one of the experts in the Forks Over Knives documentary, gives a great ‘calorie density 101’ talk officially called: How To Lose Weight Without Losing Your Mind. I have watched the following talk from Doug Lisle several times and think very highly of it. And it’s free!!! And it’s entertaining!
          As good as Doug Lisle’s talk is, it pretty much just gives you a solid understanding of the concept, but not enough practical information in my opinion. For starting to get the practical information, I recommend a talk from Jeff Novick,Calorie Density: “How to Eat More, Weigh Less, and Live Longer,” If talks aren’t your thing, the following article from Jeff covers a lot of the same information:
          Be sure to pay attention to the charts.
          Chef AJ tells people who want to lose weight to eat “left of the red line”, where I believe the red line is on a diagram of hers representing is about 650 (or so) calories per pound. And “left of the red line” is all the whole plant foods which are below 650 calories per pound. The above article from Jeff Novick gives you a good sense of which foods are “left of the red line” by food category. But if you want to look up the calorie density of specific foods, you can find many foods on the following site: Most foods on that site have the option of choose an ‘ounce’ as a size. Then you can multiply by 16 to get the calories per pound.
          It would be perfectly respectable if you are one of those people who are just not interested in the theory. You just want to dive right in and want straight how-to information. If you would rather not think about any of that (or start with the theory and then move onto this step), I have one more suggestion that Dr. Greger also recommends in his book, How Not To Die. Consider going through the free program from PCRM (Physician’s Committee For Responsible Medicine) called 21 Day Kickstart. The program will “hold your hand” for 21 days, including meal plans, recipes, videos, inspirational messages, and a forum (moderated by a very respected RD) where you can ask questions.

          (Click the green “Register Now” button.)
          At the end of the program, you will have a very good practical knowledge about how to eat with healthy and “low” (normal for most people) calorie density.
          Another recommendation that Dr. Greger and I share is to get Jeff Novick’s Fast Food videos for tasty, affordable, fast and healthy calorie density recipes. Also, on-line and free is a YouTube series of recipes/cooking shows called something like Chef AJ and The Dietician. I know that Chef AJ will not steer you wrong in terms of weight loss and providing accurate nutrition information.
          How’s that for some tips? If you give these ideas a try, please report back and let us know how it went.

          1. This is all fabulous! I have had the pleasure of hearing Doug L. speak and witnessed Chef AJ cook a few recipes out in Ohio at an FOK weekend seminar. I have followed PCRM with Dr. Barnard and his staff. I pre-ordered “How Not to Die” and have that as a resource and I have the daily dozen app, too. I recently joined Meal Mentor with Lindsay Nixon and am hoping to figure out portion control. I love my carbs… too much. I think the calorie density thing is what will help me. I have heard of but never “followed’ Jeff Novick. I am excited to do some reading and listen to some of his YouTube videos! Again, thanks so very much!!!
            Have a wonderful week!

            1. PAbbott: That’s interesting. The traditional Okinawan diet (leading to some of the longest and healthiest lived people on the planet) was 85% carbs. 69% of their diet was sweet potatoes. I don’t see how eating whole, intact plant foods which are high in starches, such as potatoes and intact grains and beans would be the problem. I would guess that the devil is in the details…what are you eating *with* those starchy foods?
              That said, if you look at the PCRM Power Plate, and Dr. Greger’s Daily Dozen, they aren’t recommending that you eat 70% starchy foods. Closer to half… I’m not an expert. I’ll be interested in hearing back from you at some point in the future if you get a chance to absorb the calorie density concept and put it into practice. Good luck!

              1. I watched the Jeff Novick presentation and it was fabulous. I think his slides and presentation were put in terms that more clearly identify calorie density to me. I think using the redline you speak of above just might be where I am tripping up. I am going to look for J Novick’s videos so I can concentrate on the best recipes to help me meet my goals. Again, many thanks!!

  39. I don’t care so much about high blood pressure. If I understand it correctly the scientific community thinks that high blood pressure contributes to heart attacks, strokes, etc. Are there any studies that show the recommended salt intake in relation to these incidences or overall mortality rate in a population?

    1. Hi Mark, there is a direct correlation between high blood pressure and cardiovascular disease (ie- strokes and heart attacks). When blood pressure is consistently high it causes stiffening of the blood vessels which are normally pliable and reactive enabling them to contract and increase blood pressure when it’s needed or relax and decrease blood pressure when it’s needed. When the vessels become stiff they lose this ability to accommodate to different circumstances, you develop something called endothelial (or blood vessel cell) dysfunction which sets the stage for the whole cascade of events that lead to heart attacks and stroke. So blood pressure is something you should care about.
      That said, yes there are studies that show salt intake in relation to incidence of strokes, heart attacks and cardiovascular disease in general.
      Here is a large meta analysis of prospective studies published in the British medical Journal where the preponderance of evidence showed a significant increase in risk of stroke and all cardiovascular disease the higher your salt intake.
      This article gives specific salt intake amount recommendations for prevention of hypertension and cardiovascular disease.
      Dr G also covered this topic extensively in this video

  40. I have a very odd question about salt and blood pressure. I am mid 50s, overweight, and not on any medications. I eat a mainly plant based diet. Over the past 5 or more years, I was on a quest to find a healthy deodorant. I tried ALL kinds and none of them worked. I ended up using one I found made in Canada. It seemed to work the best but is expensive and a pain to order (crazy shipping fees). One day I was near the city (I live in the country) and I made a visit to a Whole Foods. While in the personal products section, I asked the woman stocking the shelves what seemed to be the most popular deodorant. She held up a bottle of Thai Crystal deodorant spray. It is made of mineral salts. I made the purchase and tried it out. It worked GREAT! I was really excited. Over the past six months, I have started noticing a pressure in my neck, kind of tightening. I related it to the feeling I get when I know something is stressing me out. I ended up picking up a blood pressure wrist cuff. Low and behold, my blood pressure is now in the pre-hypertensive range. I am wondering if the salts in the deodorant could be affecting my blood pressure. Nothing else has really changed in my life unless I am just “due” for higher numbers because of my age and my weight. (I am actively working to drop some weight. I have “How Not to Die” and am aware of what I need to do to drop my numbers.) I do not add a lot of salt to my whole foods and do not eat a lot of processed foods. Again, my question here is whether or not the mineral salts could be absorbed by my skin and somehow affect my blood pressure. Thoughts anyone?

    1. Hello PAbbott,
      That’s a good question. I am a family physician in private practice, and a volunteer moderator for this website. Salt can absolutely cross the skin — either outward (when you sweat), or inward (when you put salty substances on your skin). The question is HOW MUCH salt (salty deodorant in your case) it would take to significantly raise your blood pressure. I just looked on PubMed (free, searchable data base of medical articles), and could not quickly come up with an answer. I suspect, though, that you would have to apply quite a bit of deodorant to your skin before it had a significant effect. One way you could guess at an answer would be to calculate how much sodium (in grams) you apply each time you use your deodorant. The recommended limit for dietary sodium intake is 2,300 mg per day or less. People with hypertension should probably consume less than 1000 mg. I’m guessing that no more than half of what you put on your skin makes it across to your bloodstream. So, if you are applying less than 500 mg of sodium to your skin each day, you’re probably fine.
      I hope this helps.

    1. Sea salt still contains sodium; if you don’t know already, sodium is the main component of salt (which is the component that, if consumed in excess, raises blood pressure).
      So treat sea salt as you would with table salt. Dr. Greger’s videos regarding salt still apply to sea salt.

  41. Of course they present no evidence that salt actually raises blood pressure.

    Go check Scientific American. There is no evidence that salt intake affects blood pressure in any way!

  42. Wait! The 2001 study that you show indicates that the blood pressure difference on the DASH diet with high sodium vs. the DASH diet with low sodium makes only a tiny difference in blood pressure. That’s quite a big difference in sodium intake to produce a very small blood pressure variation — don’t you agree??

  43. Well, I for one can attest that eliminating carbohydrates from your diet will make your blood pressure drop dramatically.

    I had a resting BP of 160/90 to 165/96 a few years ago when I weighed nearly 300 pounds. I tried exercise (over a year), caloric restriction, & limiting salt, nothing worked to lower my weight or had any significant impact on my BP.

    Upon advice from my doctor, I did an Atkins style diet (ketogenic) along with a 5:2 intermittent fasting regiment. I quickly dropped 30 pounds (in 30 days). And although I was actually increasing my intake of salts (NaCl, & magnesium citrate), my BP also dropped dramatically.

    I didn’t know this at first, until I had my wife take my BP one day (after reading in a blog that ketogenic diets drop your BP). In under 2 months my BP had dropped to 130/78. Within 6~7 months it had gotten down to 120/70. That’s a 40+ point systolic drop, and a 25+ point drop on the diastolic with zero drugs (only diet, no exercise).

    I religiously avoid carbs now. I use Morton lite salt (50/50 NaCl/KCl) not for BP reasons, but because I need the extra potassium (as I can’t eat potatoes or bananas). And before you say it, I only started using that well after my BP had already dropped (so it is not the reason for that). I probably use even more salt than before this diet, as the excessive amount of water I drink everyday depletes my electrolytes (upwards of 1 gallon per day). My liver requires a lot of water to make ketones, and thirst is a sure sign that I’m in ketosis.

    I don’t think I’m an isolated case, as I’ve read many accounts of other people doing a ketogenic diet having their BP significantly lowered, even while increasing their salt intake. Excessive carbohydrates, especially if your insulin resistant, makes you retain a lot more water than excess salt can. I think the other reason for the lower BP over time after changing my diet is that my arteries (were hardening) and veins (were thrombotic) recovered from the death spiral they were in thanks to doing a ketogenic diet. Did I mention that I had chest pains and edema so bad in my legs that I couldn’t stand up for more than a couple of hours a day? Yea, that’s gone now…

    I think salt can easily exacerbate high BP, but I don’t think it is the actual root cause. It is not unlike when MD’s for years and years told patients with bleeding ulcers that it had to do with stress (and only with stress). The real cause was of course a bacterium called Helicobacter pylori. Yes, stress or salt can certainly exacerbate almost any medical condition, including high BP. But it is NOT the root cause (and never was). If you think there is too much salt in processed foods, well there is usually way more added HFCS/sugar/starch in them (i.e.: 3rd ingredient in Campbell’s tomato soup is HFCS, and that’s the “high sodium” version).

    And yes, I do eat way more veg these days, usually at least 8 oz per day (usually more), as well as other high fiber foods (like, for example, flax bread). I don’t eat corn (not a veg anyways) or stuff like sweet peas, as they are too high in sugar/starch. My fare is either broccoli, cabbage, brussel sprouts, green beans, asparagus, cauliflower, radishes, & turnips. Of course, I’m dousing them with the fat my diet requires (usually in the form of Alfredo sauce).

    I know, many here are probably having a conniption fit that I’m eating meat, as opposed to being a Vegan. Well, I actually eat a lot less meat than before, and probably much less than most people do who eat a SAD. I’m eating something like a 2:1 (by weight) of vegetables to meat, although I do add a lot of dairy fat (butter, cream, cheese: aka Alfredo Sauce). That figure doesn’t even include things like my flax/chia/coconut flakes cereal (N’oatmeal), so it might even be closer to a 3:1 ratio. I’m on more of a WFOB (Whole Foods Omnivore Based) diet.

      1. Well which is it? Stress, weight, or salt that causes high blood pressure? Your kind of right about being overweight affecting BP, but your also kind of wrong, and here’s why… (long rant alert ;-)…

        My neighbor has high blood pressure, to the point that he only has one kidney left, because he let it go uncontrolled for too long. AND He is as skinny as a friggen rail, and always has been. If anything, he could stand to gain a bit of weight. So if you think being fat causes high BP, then he is the living proof that theory is bogus. Yes, it doesn’t help, but I don’t think it is a “root cause”. He also doesn’t have nearly any salt in his diet, yet he still has to be on BP meds. I think his Dr. is telling him that it’s age & stress induced. I eat more salt now than I ever did before, I have to in order to retain water. Yet my BP is lower than it has been in years, even before I got fat (which was a consequence of quitting smoking). Again, proof that salt is not the root cause either….

        Things like salt, stress, and being overweight can certainly exacerbate high BP, but if your looking for root causes, you really need to look at hardening of the arteries (AKA arterial sclerosis) for an actual root cause. When your arteries develop plaques, and harden, they are unable to easily dilate anymore, and things like salt and stress then have a much bigger impact than they would normally have in a healthy / young person. This is why a vasodilator will immediately lower your BP. This is also why you don’t see little kids with high BP, no matter how much salt, sugar, and fat they eat (although it will eventually catch up to them by their teens, because it’s accumulative)….

        What then causes AS (arterial sclerosis)? Obviously, it’s got to be diet, although smoking probably comes in at a very close 2nd. For example: I seen somewhere that smoking a single cigarette sucks up your NOS (your body’s natural vasodilator) which interferes with the proper functioning of the endothelial lining of your arteries for about four hours. But eating just one serving of fast food french fries (fried in industrially processed canola or soybean oil) interferes with the endothelial linings of your arteries for upwards of twenty four hours!!! The Standard American Diet (SAD) is very high carbohydrate, AND is replete with bad fats (industrially processed canola, soybean, corn oils) which we have been told are good for us (they are NOT). If you watch this video link, you’ll understand why these fats are sooo bad for you.

        You can trace high BP, kidney disease, obesity, diabetes, and CVD all back to a poor diet. Some of these cause another problem, in a kind of cascade effect. I.e.: A bad diet first causes arterial plaques to form, which causes higher and higher BP over many years, which leads to hypertension, which eventually leads to kidney failure if not controlled. Or another classic example is that a bad diet causes obesity, which causes diabetes, which then causes CVD, which leads to heart disease. How each persons body reacts to the same good or bad diet has to do with their genetics most likely. It’s not surprising that 7 out of 10 CVD/heart disease patients are either a diabetic, pre-diabetic, or an undiagnosed diabetic.

        Reportedly, people on low fat high carb (LFHC) diets and people on low carb high fat (LCHF) diets tend to have much better health outcomes than the rest of the population that are on the SAD (which is high carb & high fat). The thing that LCHF and LFHC diets have in common (other than the fact that they are at the extremes) is that one macro nutrient is ingested in very small amounts (fat for LFHC, or carbs for LCHF), and that all three macro nutrients are of very high quality (assuming your doing either of those diets “correctly”, and not eating “junk”). Both diets, when properly done, tend to go toward whole “natural” foods using high quality macro nutrients (even if it is the one your avoiding). For example, although I avoid most/all junk carbs, my LCHF diet does have VERY high quality carbs like flax, chia, cauliflower, broccoli, brussel sprouts, asparagus, cabbage, etc.. If you took the little bit of meat off my plate, you’d think I was a vegetarian. Obviously, I’m also avoiding the industrially processed junk oils, and sticking to unprocessed natural fats.

        I watched a horizon episode over a year ago about diets & dieting. And the interesting thing one researcher found in a rat feeding study is that both LCHF and LFHC diets seemed to have the same effect, in that neither of those rat populations gained much weight, and had fewer health problems. The 3rd group of rats were “exclusively” fed cheesecake (sugar & fat, which is similar to a SAD). They gained weight very quickly, and had many various health problems (obesity/diabetes, cancer, CVD, AND high blood pressure).

        What was learned from that experiment is that the combination of sugar and fat screws with your brains “satiety switch”, causing you to overeat. The example he gave was for a person to sit down with a bowl of sugar and start eating it by the spoonful. It won’t take very long for most people to stop eating it. Then (sometime later) do the same with a bowl of high fat cream. Again, it won’t take very long for you to stop eating it. Now take the bowl of sugar and mix it into the bowl of cream at a 1:1 caloric ratio. Most people will finish the bowl. BTW, that combination when chilled and stirred is known as “ice cream”….

        Now, it could be argued that salt IS part of a given diet. Well yes, while that is true, it is only a “micro-nutrient”. So it’s going to have less of an impact than the big 3 macro nutrients (carbs, fat, & protein) will in the long run. I mean, you can sit there and take a bunch of vitamins (micro nutrients) and then think that will allow you to eat a shit diet (which many stupidly people do). Or you can stop eating salt (another micro nutrient), and think that’s going to solve your underlying high BP problems. Obviously taking vitamins or reducing salt intake in both of these examples helps out in the short term, but only a little, and they DO NOT address the underlying problem (hardening of the arteries caused by a shitty diet).

        Okay, sorry for the long rant, but those are my thoughts on this subject.

        1. I do think you make some good points. No doubt that for most people, gaining a lot of weight will increase blood pressure. Losing a lot of weight will decrease blood pressure. The types of foods you’re eating, your level of cardiovascular exercise, whether you’re a smoker, etc., etc. are all quite important factors. Certainly, not all carbs lead to poor health outcomes. In fact, whole food sources, such as fruits, vegetables, and intact whole grains are good choices and are typically very high in a wide array of nutrients. When I lost a bunch of weight and still consumed a diet of about 60% carbs, my blood pressure dropped to its lowest level ever (90/60 — a bit too low, perhaps!). Carbs are not the enemy if you’re choosing wisely.

          1. Like I said, it seems that the “well balanced” SAD diet is actually the worst thing to be eating, and the two extremes of LCHF & LFHC seem to both be better for you. I myself like LCHF, because fat free chocolate is just nasty, among other things. And it is also a lot easier to calorie restrict on LCHF, as I can go a few days without eating if need be. I couldn’t hardly make it ten hours when I tried that when I was still eating carbs, then I’d tend to over eat (again, CARBS). When your insulin resistant like I was, carbohydrates basically become an addiction paradigm of sorts, and the only way to cure it is to go “cold turkey” (or bacon) if you will.

            But getting back to the subject at hand (high BP & salt), again my basic premise still stands. Salt, stress, and being overweight are all things that “can” exacerbate high BP, but I think that saying any of those are the cause is a bit of a stretch. I’ve given you two examples that prove (or at the very least contradict) that both weight (my skinny neighbor with high BP) and high salt intake (me, with normal BP) do not play a “root cause” roll in high BP. Atherosclerosis does explain why a skinny person who doesn’t take much salt (and who seems to have a very even temper), but is still eating a SAD diet, has such high BP problems. A fat person is much more likely to have atherosclerosis, as I am sure I did, as the edema in my legs (and my formerly high BP) was a vascular sign of that. A LCHF diet completely reversed that for me. But now that I’m not fat anymore, and (more importantly) I don’t have atherosclerotic/vascular problems anymore, I can eat upwards of 3+ grams of salt a day, and never give it a second thought.

            I’d be willing to bet that if you took people with high BP problems and gave them a CAC scan (Coronary Arterial Calcium) you would see that the majority of them have a much higher CAC score than compared to people with normal BP. There will always be a few outliers in there that will have a genetic or kidney problems to begin with, but for the general population it is most likely atherosclerosis that is the root cause of high BP…. And the leading cause of atherosclerosis is probably diabetes (again 7/10 heart patients are pre/diabetic), which is caused by poor dietary habits (sugar & fat) that western societies seem to support.

  44. My doctor told me to RAISE my salt intake because of my rather low bp. Is this really a good thing to do? Or are there other ways to raise bp?

  45. Hey Isabel, thanks for writing. The only indication there seems to be for INCREASING salt intake seems to be in persons with orthostatic hypotension. These folks are also typically treated with drugs as well. Sounds to me like you’re saying that your BP is low, but not so low that you might faint. If this were the case then he would have put you on a drug that affects your hormone levels as well, which you did not say was the case here. That being said, recent research indicates that the ratio between sodium and potassium intakes are more important than either alone, so as long as you are a good consumer of fruits, veggies, legumes and whole grains, then you might not experience harm from including some extra salt in your diet.

  46. A 2017 report from Boston University School of Medicine that followed a large number of people over 16 years concluded that sodium did not have an effect on blood pressure. I wonder if that study was funded by the salt industry in some way. Dr. Greger, have you seen the study?

    1. Hello RonM,
      Thank you for your question. I’m a family doctor with a private practice in lifestyle medicine and also a volunteer moderator for this website. I just Googled “2017 Boston University study of salt and hypertension”, and found numerous references to the study but could not find the actual study. I also checked on the PubMed website and couldn’t find it. Do you have the reference to the study? From the Google hits I looked at, one thing is clear: they looked at 3 groupings of sodium intake: 4000 mg/d. I saw a graph showing that the group eating <2500 mg/d had HIGHER blood pressure than the other two groups, throughout the 16 year duration of the study. Interestingly, the blood pressure of all 3 exposure groups rose steadily over the 16-year study period. I think there are several issues here.

      1) People who consume 2400 mg/d of sodium per day, who would be in their lowest exposure group, are still eating way too much sodium. There is a threshold effect with sodium consumption, and once you get over about 1000 mg/d, you’re eating too much. If you consume in the range between about 1500 and 5000 mg/d, blood pressure rises much less steeply as sodium consumption goes up. Our bodies evolved during a time when most humans ate less than 500 mg of sodium per day. Dr. Greger has done some videos looking at societies in Africa who eat traditional diets with under 500 mg sodium per day, and their blood pressure does not rise at all as they get older; contrast this with the US where it is “normal” for blood pressure to increase with age.

      2) You mention the salt industry. It is clear that they put out mis-information in an effort to support their bottom line. Here are a couple of videos by Dr. G about that issue:; and

      3) Finally, some people are “salt resistant” — meaning that their blood pressure doesn’t change much as sodium intake rises. Here is a study showing that about 33% of Americans are “salt resistant”: So, studies that show little change of blood pressure as sodium intake rises might (by chance) have a higher than usual proportion of these salt-resistant subjects.

      I have personally studied this issue of the relation of salt intake with hypertension. I wrote a paper about it when I was in public health school (MS in epidemiology, Harvard) in the late 1970s. There are numerous published migrant studies of people who move from a country where they eat a traditional diet (low-sodium, plant-based) to a Western country. They all find that their blood pressure rapidly takes on the characteristics of the country to which they move — i.e. it gets higher, and it continues to rise with age. That doesn’t prove anything, of course, but there are also countless animal studies published which study what happens as sodium intake goes up, and most of them show that high sodium intake leads to higher blood pressure.

      This issue has been resolved to my satisfaction for over 40 years: Salt is a major, if not THE major contributor to causing hypertension.

      I hope this helps.
      Dr. Jon
      Volunteer moderator for

      1. Thank you for that information. It was very helpful. I have had high blood pressure since my late teens (now 56), despite being normal weight, a lifetime runner, weight lifter and now (for the past 6 years) on a strict low fat, plant based diet (Dr. Esselstyn’s program) and I still have high blood pressure. I try to manage my salt intake, but maybe I need to go even lower, like to 500 mg. or less a day (sounds boring even for my simple tastes).

  47. Hello Ryo, and thank you for your question.
    I am a family doctor with a private practice in lifestyle medicine; also a volunteer moderator for this website. Your question has two parts. First is whether or not blood pressure tends to be higher in the morning, as compared with other times of the day. The answer is YES. That’s because of our normal diurnal (daily) fluctuations in levels of hormones such as cortisol and neurotransmitters like norepinephrine. In the morning our bodies get “revved up” with these wake-up hormones, and the result is that blood pressure tends to be higher in the mornings. That is why heart attack incidence is also highest in the mornings. This is a little over-simplified, but true in general.

    The second part of your question is whether or not eating salt raises blood pressure. Most doctors, including Dr. Greger, the American Heart Association, and me, believe the answer is clearly YES, but there remains some controversy. I think part of the controversy comes from the fact that, while most people are “salt-sensitive”, some are “salt-resistant” — see my response to Ron M’s question from 10/24 (above). But I think a lot of the controversy is due to misinformation put out by the salt industry. See this video by Dr. G:

    I hope this helps.
    Dr. Jon
    Volunteer moderator for

  48. My husband walks between 30000 to 50000 steps a day in his job. We would like to know if excessive exercise or exercise in general, affects how our bodies utilize salt intake through our plant-based diet. Does he or does he not burn off excess sodium through his walking?

  49. Hi I’m a moderator with NutritionFacts. Thanks for your great question.
    We don’t burn sodium like we burn calories so to speak for energy. We do loose it in our sweat and other body fluids. We need a very specific balance of electrolytes such as sodium but also potassium, magnesium and others in our blood. Our bodies are constantly working to maintain this balance of electrolytes our body desires. If you are eating a whole food, plant based diet, you should be getting all the electrolytes you need, and most important putting your body into a state of health where it can regulate the electrolyte balance. You should not need to add salt into your daily diet , even if you are active. Hyponatremia, or low sodium levels can cause severe acute symptoms such as confusion, nausea, vomiting, muscle cramps. It can be an acute life threatening emergency, but is not typically a chronic issue for active people. We usually see this in situations like heat exhaustion or sometimes with severe vomiting and diarrhea.
    I’m a marathon runner and long distance triathlete myself. And I have found the only time I need to use things like gatorade (I make my own homemade version which is far less processed) to help with electrolytes is during long workouts- like when I run or bike for several hours at a time. If your husband is active for long periods of time in heat or is sweating a lot, he may benefit from an electrolyte drink during activity, but should not need to consume extra salt. If he is feeling well, the electrolytes are probably in good balance. It is an easy blood test of a physician to order if you want to check your electrolytes. It’s typically a BNP or CMP (basic metabolic panel or complete metabolic panel).

    Hope that helps.
    NutritionFacts Moderator

  50. I am curious if Dr. Greger and the staff have looked at this recent Meta-analysis:

    The results were surprising to me.

    “The mean dietary sodium intake was reduced from 11.5 g per day to 3.8 g per day. The reduction in SBP/DBP in people with normotension was about 1/0 mmHg, and in people with hypertension about 5.5/2.9 mmHg. In contrast, the effect on hormones and lipids were similar in people with normotension and hypertension. Renin increased 1.60 ng/mL/hour (55%); aldosterone increased 97.81 pg/mL (127%); adrenalin(sic) increased 7.55 pg/mL (14%); noradrenalin increased 63.56 pg/mL (27%); cholesterol increased 5.59 mg/dL (2.9%); triglyceride increased 7.04 mg/dL (6.3%).”

    Essentially, Blood pressure went down very little in people with normal blood pressure and a bit in people with high blood pressure, but it also generally increased cholesterol, triglycerides, and adrenaline.

    Now Salt is Sodium Chloride, and I believe Chloride has a stronger effect on BP than Sodium. So perhaps in the attempt to drop sodium levels these people stopped also eating vegetables that have some amount of sodium. Not sure, but possible.

    I think eating a whole food plant based diet you will find you do need very little salt to make things taste good, but salt does seem to be important.

    1. The study you cited was a meta-analysis which we know can be easily skewed if designers have a reason to look for results. In this case of the 185 studies cited 18 were funded by the pharma or food industries and funding of an additional 44 studies was not known. This could indeed affect results. You idea that one should look at what the participants were eating (less vegetables) might be relevant esp if high cholesterol foods were substituted. Looking at the stronger studies Dr. Greger cites on the damages of salt compared to this one meta-analysis, it seems prudent to stay with no or very low salt. As you said one may need very little salt to make things taste good, and if one is creative, other substitutes can be found, such as lemon, vinegar to get to that no-salt leve.

  51. We would love to see any peer-reviewed unbiased clinical research that shows that chloride intake correlates with blood pressure levels.

    Dr. Ben

  52. My understanding has been that salt raises blood pressure in people who have trouble eliminating salt or who retain salt, but not in people who don’t have this problem, unless they consume excessive amounts of salt. So every population based survey on salt intake and blood pressure gives this correlation, but would the results be the same if you only reduced the salt intake of people with normal to low blood pressure?
    I play squash regularly and when it’s warm, my sweat is so salty I have to wash my face in between games or my eyes start burning. I am also prone to severe cramps after a prolonged session, and the only thing I’ve found that eased those cramps was to have a glass of water with a teaspoon of salt in it, which solves the problem within seconds. I have had the same response with severe cramps from heat exhaustion.
    I recently saw an interview with a respected health specialist explaining how the descendants of slaves in the US are more prone to high blood pressure problems because as a population they retain salt in their bodies more than the general population. This was because those that survived the horrific conditions in the holds of those slave ships were the ones who retained salt, with the inadequate food and water provided, those like me who processed salt more easily did not survive as well. This unnatural selection on the voyage over has given this population an added curse of salt sensitive high blood pressure to deal with.
    All of Dr Gregors examples seem to me to include similar groups of salt-retaining individuals, who will definitely benefit from a low salt diet. What I need to know is how important is it for me to reduce salt in my diet, and would it be unhealthy for me to do so? I have no blood pressure issues.
    One last thing: I found an old home economics textbook once from the fifties, and on the first page it said “always add salt to the water before boiling vegetables, or many of the nutrients will go into the water instead of staying in the vegetable”. I wonder how many nutrients have been thrown away with the cooking water?

  53. Don’t forget to follow the actual evidence, which clearly shows that sodium intake correlates with hypertension, especially with advancing age. Sure there are people that are NOT sodium sensitive such that they can eat significant amounts of sodium without an increase in BP, but this is less common than those that ARE sodium sensitive…again, the number of sodium sensitive individuals increases with age. And don’t forget that excess sodium intake correlates with many diseases independent of blood pressure, so just because you don’t have high BP doesn’t mean the sodium you’re eating isn’t still increasing your risk for disease and premature death….it is.

  54. I have looked for an answer to no avail.
    If studies show that high blood pressure is an adaptation to environments with low salt. Why do they suggest one lower salt intake to lower blood pressure?

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